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| Q&A: Dr David Hartman on Head Injuries (824 Posts)
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See ya
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On 5/28/2004 isabelle
wrote in from
(68.7.nnn.nnn)
I had a "back and forth" going, am a boarder and WAS interested in your opinion.
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Isabelle's opinions, Part the Second
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On 5/28/2004
Dr. Dave
wrote in from
(24.13.nnn.nnn)
Isabelle,
I partially agree with you about excess salt (sodium). It's associated with hypertension in a substantial minority of individuals. But readers of my "Corner" know that if it's not validated by refereed clinical research and good science, I'm not going to stand behind it. Acidic food as toxic is a health food myth. Your stomach contains stronger acid than anything you could possibly eat. Let's not debate this here and let's keep our back and forth to issues that interest boarders.
DrDH
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ASTM v. CPSC v. Snell
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On 5/28/2004
Dr. Dave
wrote in from
(24.13.nnn.nnn)
Mark,
ASTM is another voluntary standard setting body. It's similar and in some cases identical to CPSC. Snell may be a little more stringent.
See the following link: http://www.smf.org/articles/bcomp.html
DrDH
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one last thing
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On 5/28/2004 mark
wrote in from
(192.215.nnn.nnn)
i e.mailed them, and this was the response:
the ripper 2 helmet we offer in sizes youth, small and medium which
fits sizes: hat size 7 to 7-1/4, or measured circumference in inches of 22
to 22.75, meet the following standards: ASTM F-1492 Skateboarding, ASTM F-1447 Bicycling, ASTM F-2040 Skiing and Snowboarding and USCPSC bicycling. this is on the label in the helmet.
it also comes in a large/adult size. i might try one of these.
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Opinions
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On 5/28/2004 isabelle
wrote in from
(209.66.nnn.nnn)
Facts are not opinions....."Isabelle's opinions are just that" and some of my post certainly is, BUT excess salt/acidic foods harmful effects on the body is NOT opinion, but FACTS!
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Look for the Label
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On 5/28/2004
Dr. Dave
wrote in from
(24.13.nnn.nnn)
Mark,
Let us know. Remember that a mfgr *saying* they meet a standard is *not* the same as submitting their product for actual CPSC or Snell testing. Gotta have the label.
drdh
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helmet again
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On 5/28/2004 mark
wrote in from
(64.166.nnn.nnn)
dave, thanks a lot for your input! just yesterday a friend of mine mentioned 'w helmets' to me. i have no idea if their skate helmet is in any way better than others (and they're rather pricey), but apparently they meet the 'ASTM F 1492 for skateboarding' standard (that's mentioned on their website). i'll try to find out more.
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Advice on Advice
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On 5/27/2004
Dr. Dave
wrote in from
(24.13.nnn.nnn)
Just want to emphasize here that Isabelle's opinions are just that. It's good that she's found a solution that works for her, but others may be helped in different ways. There's no single diet or pill that helps everyone. Use what works for you and collaborate with your doc to find the best strategy.
DrDH
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Mark's Helmet
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On 5/27/2004
Dr. Dave
wrote in from
(24.13.nnn.nnn)
Mark,
It's cool that you're thinking of this. You'll board longer and safer. In this case, it's all in the label and the type of helmet, not necessarily the brand. Look for Snell or CPSC stickers on the inside. Snell is better, but CPSC is fine. If you speedboard, look for a full face helmet made for that purpose or a motorcycle helmet. For slow carving, a regular skateboard helmet with one of those stickers is what you need. It's a million times better to wear *any* Snell or CPSC helmet than it is to go bare-skulled, so wear what's comfortable or you'll find excuses not to wear it. You want a shape that covers the back and sides and forehead, so those racy bike helmets may not do the job. Boarders fall differently from Bikers, so get a helmet with that full surround protection. Let us know which one you wind up with.
One more thing. If you take a major header on the helmet, bury it with honors and get another. Most are made to take one major hit and that's it.
Sk8safe DrDH
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Advice
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On 5/27/2004 isabelle
wrote in from
(209.66.nnn.nnn)
Rereading my previous post, I want to verify/clarify that I mean NO HARM to those who devote themselves to helping others.........I don't want to seem crass, but I've had to listen, research, try and decide what works for myself.
Western medicine has so many problems, our U.S. food supply is fully polluted with CRAP/artifical material, we unwittingly look for unhealthy alternatives to health.
Lastly, tomatoes are a high citrus food, so use them in moderation.
Study organic food sources, be suspicious of "products" that claim to help you feel better, try to minimize ALL drugs taken.
PLAY ON PLAYERS!
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Glucosamine with Chondroitin
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On 5/27/2004 isabelle
wrote in from
(209.66.nnn.nnn)
Nothing will work to heal swollen/sore joints if you consume excess salt and/or citrus/acidic products...
Don't waste money, change your eating habits and you will feel GREAT without pollutting your body with even more unneeded stuffs.
The LEADING cause of athritis (sp?)is salt/acidic foods intake and genetic dispositions.
Go do some research for yourself, rather than take anyone's advice, including doctors...........food 4 thought
Personal history,...I've been extremely abusing my body for athletic play since I could walk. I started skating at 37 years old after having 2 children.
One broken collar bone, shattered shoulder blade, blown-out inner ACL on my knee, and 3 dislocations on my shoulder are some of the worst injuries I've gotten skating/surfing/snowboarding.
I eat only organic foods, drink lots of water, don't smoke cigarettes, do yoga daily and stay extremly fit.
I was still having occasional joint discomfort; the conjoint/msn stuff made a little difference and I liked the help, but asked my chiropractor for advice. He told me to stop or severly moderate acidic foods (citrus, coffee etc) AND not consume salted foods. I went cold-turkey for 2 weeks AND I COULD NOT BELIEVE HOW GOOD I FELT.
So now, my oral food pleasures are less but it's definately worth it. Pain sucks and if I'd had a CLUE as to how easy it was to fix mine, I'd done it yyyeeeaaaaarrrrrrrrs ago!
Americans are WAY too prone for the "pill" fix.....Capitalism feeding your brain with false facts.
Educate yourself!
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helmet
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On 5/27/2004 mark
wrote in from
(66.120.nnn.nnn)
hi, not exactly a health issue (but it might become one...), but do you have any input on what the safest skate helmet -in terms of safety standards- would be? or are all the big names (pro-tec, s-one etc.) pretty much the same?
thanks
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Hugh r's unusual medication side effect
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On 5/23/2004
Dr. Dave
wrote in from
(24.13.nnn.nnn)
That's a new one on me, Hugh r. Enjoy. DrDH
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Aspirin
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On 5/22/2004 Dave
wrote in from
(67.168.nnn.nnn)
Thanks. I started taking the LDA 81mg ASA due
to my age. I don't have a strong family hisory
for MI and don't smoke. My blood pressure is under
control, 25mg Atenolol. I will continue to take
LDA and wear a helmet.
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Glucosamine with Chondroitin
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On 5/22/2004 hugh r
wrote in from
(69.166.nnn.nnn)
I have been taking 1500/1200mg of this daily for about 6 months now and must say that it has been a God send for me.
Previously I would have a hard time getting out of bed in the middle of the night and would experience a considerable amount of joint discomfort whenever the humidity would rise. I live in a dry desert that is considered humid at anything above 15%... so a cloudy or rainy day would kill me! I could tell the weather change from my joints faster than the local weather man!
Now though... he is more accurate than I am, and I couldn't be happier. The frequency of the discomfort, it's duration, and it's severeity have dropped by an easy 80%. My worst days now are what my best days used to be.
Only side affect that I've noticed, and it's not even a bad one (and I'm not positive its the pill... might be age) is that I am finding the more ample figured women much more attractive than I used too... HR
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DrD. to D2
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On 5/22/2004
Dr. Dave
wrote in from
(24.13.nnn.nnn)
Dave, Also, for what it's worth, I'm over 40 and take the stuff too.
DRDH
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Dr. Dave to Dave
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On 5/22/2004
Dr. Dave
wrote in from
(24.13.nnn.nnn)
Dave,
As they used to say on MTV's cartoon "The Head" - "It's complicated." First, you're probably on low dose aspirin (LDA) because you've got a risk for heart problems, atherosclerosis, etc. As such, LDA is probably one of the cheapest and best things ever found to reduce MI risk. There's also some literature suggesting that it decreases polyps and colon cancer, so it's potentially good stuff.
However, as you might guess, docs are not exactly falling all over themselves investigating whether boarders on aspirin bleed better than non-boarders. Most of the data look at the geezer generation - older than 60.
One study that specifically looked at LDA was pretty optimistic: (Journal of Neurosurgery. 2003 Oct;99(4):661-5. "Low-dose aspirin prophylaxis and risk of intracranial hemorrhage in patients older than 60 years of age with mild or moderate head injury: a prospective study." by Spektor S, Agus S, Merkin V, Constantini S.) found "that LDA does not increase surgically relevant parenchymal or meningeal bleeding following moderate and minor head injury in patients older than 60 years of age."
On the other hand, in Neurosurgical Review. 1992;15(1):21-5.
"Aspirin as a risk factor for hemorrhage in patients with head injuries." Reymond MA, Marbet G, Radu EW, Gratzl O. found that patients taking aspirin were at elevated risk for developing chronic subdural hematoma following head injury.
Finally, in a group of patients who were both geezers (75 y.o) and who took a major header, There were 14 deaths (38%) in the anticoagulation group, versus 3 deaths in the control group (8%) (p = 0.006). In the anticoagulation group, 4 of 12 patients (33%) taking warfarin died, whereas 9 of 19 patients (47%) taking aspirin died (p = 0.285). (J Trauma. 2002 Oct;53(4):668-72. Intracranial complications of preinjury anticoagulation in trauma patients with head injury.
Mina AA, Knipfer JF, Park DY, Bair HA, Howells GA, Bendick PJ.) I don't have the full article in front of me, but I suspect these geezers were also on higher doses than LDA.
Even more complicated is the fact that other things unrelated to head injury increase your risk of bleeds, including uncontrolled high blood pressure and smoking.
So, bottom line is that if you have a family or personal history of heart disease, there is nothing out there to suggest that LDA is going to mess you up and a lot of stuff to suggest that LDA does reduce risk of MI.
Needless to say, watch out for the complicating risk factors like hypertension, and don't smoke! ALWAYS wear your helmet, and if you do take a header, go to the ER for ANY unusual symptoms, e.g., bad headache, blurred or double vision, slurred speech, change in mental status. etc.
Good luck and good sk8ing DrDH
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Aspirin risks over 40 yrs.
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On 5/22/2004 Dave
wrote in from
(67.168.nnn.nnn)
I am 43 yrs old and have been taking
81mg ASA per day to reduce risk
of MI or stroke. How much am I
increasing my risk of bleeding
subdural hematoma (sp) etc. I
board 1-3 times a week. Thanks
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The Grey Zone
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On 5/12/2004
Dr. Dave
wrote in from
(24.13.nnn.nnn)
Haim,
It's not YOUR job to diagnose you! If one doc is not sure, go to another university hospital and bring your previous records. Pin them down, do not go undiagnosed or untreated, whatever it is. In the meantime, stay cool (literally) and skate easy if you feel up to it.
drdh
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Good news..and thanks
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On 5/12/2004
Haim
wrote in from
(62.219.nnn.nnn)
First off - thanks for that great reply. Gives me alot of hope, and useful information. Second thing is I just got back from my spinal tap (this disease goes to 11..). There was alot of disagreement between the head of the dept. and the neurologist who originally told me it was 80% sure MS, according to the MRI. Basically, he thinks the clinical signs don't support MS and the MRI may be too sensitive to go so far with. I'll get the results of the ST in a few days and the visual brainstem response next week, so I'll have more info then. I'm mostly concerned now with being caught in the grey area - some symptoms, but no treatment...and does that mean I can skate and exercise aggressively, or not? In the meantime, I'll try to just listen to my body and not overdue it.
Oh - I live near Haifa,so it is not SOOO hot, like in the Negev. I never skate until evening, anyway. Even when I'm feeling tip-top.
Thanks again,
H
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Haim another thing
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On 5/12/2004
Dr. Dave
wrote in from
(24.13.nnn.nnn)
Also, if you live in the Hot Zone, do outdoor exercise early morning or later evening when things cool off. There's almost no way to stay cool in the middle of the Negev at noon unless you're going wateraerobics in a tub of crushed ice. . . .drdh
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Herbn and The Pill
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On 5/12/2004
Dr. Dave
wrote in from
(24.13.nnn.nnn)
Herbn,
Check the list archives. Glucosamine with Chondroitin is good stuff, supported by good science. People seem to like Cosamin DS as the best over-the-counter brand.
DrDH
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No Sweatin with the oldies for Haim. . .
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On 5/12/2004
Dr. Dave
wrote in from
(24.13.nnn.nnn)
Haim,
Complicated question. First, if you've got Lyme disease, you need to see a specialist and see if you need to get on antibiotics, etc. That's first priority. DOn't wait and don't mess with it. Get a differential diagnosis between MS and Lyme. This is not something to wait on, if you've got a positive MRI.
If you've got MS, there's some good news about exercise Here's the poop from the MS Information Sourcebook, produced by the National MS Society.
"In addition to being essential to general health and well-being, exercise is helpful in managing many MS symptoms. A study published by researchers at the University of Utah in 1996 clearly demonstrated the benefits of exercise for people with MS. Those patients who participated in an aerobic exercise program had better cardiovascular fitness, improved strength, better bladder and bowel function, less fatigue and depression, a more positive attitude, and increased their participation in social activities.
Inactivity in people with or without MS can result in numerous risk factors associated with coronary heart disease. In addition, it can lead to weakness of muscles, decreased bone density with an increased risk of fracture, and shallow, inefficient breathing.
An exercise program needs to be appropriate to the capabilities and limitations of the individual, and may need to be adjusted as changes occur in MS symptoms. A physical therapist experienced with the unique and varied symptoms of MS can be helpful in designing, supervising, and revising a well-balanced exercise program. Any person with MS who is initiating a new exercise program should also consult with his or her physician before starting.
Periods of exercise should be carefully timed to avoid the hotter times of the day and prevent excessive fatigue. With some guidelines, a good exercise program can help to develop the maximum potential of muscle, bone, and respiration, thereby avoiding secondary complications and gaining the benefits of good health and well-being."
Keep some ice water around. Don't over-exert. Maybe get one of those frozen headband thingies to wear, and keep seeing your doctor and/or MS specialist. As long as you don't have neurological symptoms related to weakeness, balance, incoordination or other motor problems, you can skate - carefully! Symptoms change in MS so if you start developing any of the above, see your neurologist immediately and don't do any extreme sports, including skating. Lesions in MS appear to come and go, so get retested every now and then do see what happens. Needless to say, where the helmet.
Best of luck. There are good treatments for both Lyme and MS. Be aggressive about getting whichever is appropriate. Let us know, we're with you.
DrDH
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don't shoot, Herbn
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On 5/12/2004
Dr. Dave
wrote in from
(24.13.nnn.nnn)
Hey Herbn,
By "access" to cortisone, I'm assuming you've got a source that isn't your doc. I wouldn't use it unless you get the guy in the white coat's approval. The reasons being (1) the research says it's not all that effective and (2) injecting anti-inflammatory steroids can weaken tendons. You need to check out why you be wobbly in the first place. Orthopods and/or sports med docs are your best bet. If you've got numbness, shooting pain, etc., a neurologist might help.
Let us know and good luck. DrDH
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Lyme's disease
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On 5/12/2004
Haim
wrote in from
(62.219.nnn.nnn)
That is an interesting thought about "chilling". The unfortunate part is that I live in Israel, and it is kind of hot here....
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