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| Q&A: Dr David Hartman on Head Injuries (824 Posts)
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Dred Mods
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On 12/28/2004
Dr. Dave
wrote in from
United States
(68.74.nnn.nnn)
Craig, coupla more things for your helmet-challenged buddy:
1. DON'T take the padding out of a helmet or mess around with it by moving, cutting replacing with something else. You are basically trashing the engineering and safety stats of the helmet if you do that. If the helmet doesn't fit with your hairstyle, get a bigger helmet or get a smaller hairstyle. Don't mod the helmet on the outside either. Any add on "aero" scoops or cones changes the way you could fall, and you risk twisting or breaking your neck and/or severe brain injury.
2. Repeated concussions tend to have an additive effect, so tell your buddy to be extra careful. For evidence of that, look at boxers who have their heads slammed around during their career. They can develop what is called "dementia pugilistica" or boxing dementia just from having the brain whacked around a lot. Unconsciousness is not necessary.
DrDH
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Helmets and Dreads and Blood Clots Oh My!
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On 12/27/2004
Dr. Dave
wrote in from
United States
(24.13.nnn.nnn)
Craig,
There's nothing wrong with dreadlocks if the helmet fits over them closely. They would be an additional, but minor shock absorbing layer. The one thing you should tell your blood clot buddy is to give that helmet a proper burial and buy a new one. You can't re-use them with any assurance of safety.
DrDH
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shoulders
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On 12/23/2004
slim
wrote in from
United States
(68.126.nnn.nnn)
I dislocated/separated my shoulder in a motorcycle crash in '91 and needed to have it repaired surgically. I couldn't move the arm at all but after the surgery and several months of rehab I was fine. And like the say, chicks dig scars. The worst was not being allowed to surf/swim for six months (even though I felt strong enough earlier). I have about 80-90% motion and almost never have any pain. Why am I writing this? Just to say that though it's a short-term bummer, in the long run the surgery can fix you right up so you don't have to worry about it anymore. And I want to recommend waiting the full time before skating, surfing, whatever that the surgeon recommends and doing all the rehab. Friends have rushed back to activity too soon and just ended up reinjuring themselves.
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Brainstem
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On 12/22/2004
Pat Chewning
wrote in from
United States
(24.21.nnn.nnn)
Brainstem - The lower extension of the brain where it connects to the spinal cord. Neurological functions located in the brainstem include those necessary for survival (breathing, digestion, heart rate, blood pressure) and for arousal (being awake and alert).
See diagram here: http://www.waiting.com/brainstem.html
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blood clot guy
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On 12/22/2004 craig
wrote in from
South Africa
(168.209.nnn.nnn)
The guy with the blood clot and fracture smashed in the front of his mtb helmet a year ago, resulting in concussion, with a very scary loss of memory. The helmet was made to look pretty again and the padding was taken out to fit a head of big dreadlocks.
Are dreads and helmets a deadly combo??
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Brain stem
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On 12/20/2004 mikez
wrote in from
South Africa
(198.54.nnn.nnn)
Where, precisely, is the brain stem located?
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Palmer's Orthopod Girlfriend
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On 12/17/2004
Dr. Dave
wrote in from
United States
(68.74.nnn.nnn)
Hey Palmer,
The insurance company will probably not cover your girlfriend resetting your shoulder, doing physical therapy on you, or performing surgery. Leave it alone until you get to the doc.
Dr. Dave
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MY SHOULDER
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On 12/17/2004 PALMER
wrote in from
United States
(64.12.nnn.nnn)
THANKS FOR THE REPLY GUYS. THE THING IS I DID IT SATURDAY AND NOW I WOULD SAY 90% OF THE PAIN IS GONE. IT JUST FEELS REALLY TIGHT AND IT STICKS UP MORE THAN MY OTHER SIDE DOES. I HAD MY GIRLFRIEND TUG AWAY AT IT TO SEE IF IT WOULD DROP BACK DOWN BUT NO LUCK. I CANT TELL IF IT IS STILL OUT OF PLACE OR IF IT IS JUST SWOLLEN.
PALMER
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Palmer's Shoulder
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On 12/17/2004
Dr. Dave
wrote in from
United States
(68.74.nnn.nnn)
Palmer,
Geo and Dave G. have it right. Separated shoulders may need to be surgically closed up again, but it would be an orthopedist/orthopedic surgeon to give you the word on that. Initially, your ortho will probably help you get the acute symptoms down and maybe send you to phys. therapy. Just as a side note, insurance carriers tend to spring for treatment if it's recommended by the Proper Person, and in your case, the Ortho Guy is the Proper Person.
So, yes, you need to go to an ortho guy. Don't just let it go because if it heals badly or keeps separating, its going to be harder to fix down the road.
Let us know how it goes and don't fall on it in the meantime. . .
DrDH
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Palmer's "delima"
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On 12/16/2004 Dave G
wrote in from
United States
(207.69.nnn.nnn)
Geo is right! I use my shoulders in "um-natural" positions daily thru the rafting season. And have dislocated my right side over 50 times(because I didn't have it fixxed asap my left sode is tighter and I now rely on it for things once opposite. My right side has gone thru 2 surgerys and my Doc cusses me every time I visit him that "I'm too stubborn" Get it checked by an ortho..you may just need some therapy and strengthening exercises after it become stabile. Ignore it and it will haunt you for years! You're not a pencil pusher,are you? If you want to get it right...treat it right! After 2259 stitched..2263 (if you count vasectomy) I'm pretty up on the downs of abuse and neglect! The good doc's do wonders these daze!
OUCH!!! hitting that "P" from an off linear position hurt!! Get the pic???
GEO call me or send me your # Haven't talked since to 70's
304-574-0227
Enjoy,
Dave G
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Palmer's shoulder
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On 12/16/2004
Geo
wrote in from
United States
(64.207.nnn.nnn)
I am not a Dr, but I HAVE separated my shoulder. If you really separated your shoulder, chances are you tore the cartilage that holds your shoulder together. If you don't have the surgery to repair the torn cartilage it will keep popping out whenever you apply pressure to it. I opted to have the surgery which meant 4 pins put in for 6 weeks until it heals back, then quick surgery to have them taken out. It sucks but I have not had any problems since. -Geo (my .02)
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SHOULDER
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On 12/16/2004
PALMER
wrote in from
United States
(152.163.nnn.nnn)
QUICK QUESTION FOR YOU DR. DAVE. I SEPERATED MY LEFT SHOULDER ON SAT. WENT TO THE ER AND THEY REFERED ME TO AN ORTHO. IS IT REALLY WORTH GOING?
PALMER
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And one more thing for Mikez
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On 12/15/2004
Dr. Dave
wrote in from
United States
(68.74.nnn.nnn)
Mikez,
You didn't say whether your friend had a helmet on. If he didn't, he's pretty lucky it wasn't much worse. If he wasn't wearing one, see if you can get him into a helmet next time.
drdh
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Mikez' buddy's blood clot
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On 12/15/2004
Dr. Dave
wrote in from
United States
(68.74.nnn.nnn)
Mikez,
You're partly right. . .if the blood clot is a 'huge, huge thing.' Small blood clots will resorb and take care of themselves. If the blood is emough to compress the brain or cause intracranial pressure to rise, they will typically try to get it out, no questions asked and sooner rather than later.
Your buddy should be monitored for changes in behavior, mood, thinking or learning over time. Problems in those areas would not show on an MRI, but are fairly common after a traumatic brain injury. If anybody notices things like irritability, depression, forgetfulness, impaired vision, impulsive behavior (more than before the fall), your buddy should see a neurologist or neuropsychologist to get it checked out. He shouldn't be on a board again until he gets a doc's say so.
DrDH
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More about Lloyd's Accident
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On 12/15/2004
Dr. Dave
wrote in from
United States
(68.74.nnn.nnn)
Thanks Bob Schwarz for finding this and sending it to me:
By Arjan van Oosterhout
"He was a daredevil, a speed junkie. Fearless, but it was nerve-racking for his old man."
On Tuesday the nightmare became reality for Ian McPherson, when he gave the okay to switch off the machines keeping his son, Lloyd, 14, alive.
And in a cruel irony, it seems that Lloyd's safety helmet may have caused the massive injuries he suffered during a skateboarding accident at the weekend.
'I could see Lloyd dying in my hands'
He was taking part in the Red Bull DHX event - an international downhill competition with skateboarding and in-line skating - near Betty's Bay on Sunday.
It was the first time that Lloyd, of Llandudno, had made it to the second round of a big downhill competition.
During the race he lost control of his skateboard and crashed into a bale of hay next to the track.
First aid worker Lorna Rosslind, who was standing nearby, said: "He landed flat on his back. Lloyd used a helmet with a cone at the back for aerodynamic reasons.
"Normally in an accident the cone would break away, but because he had a totally flat landing Lloyd's head took the full impact of the cone, causing massive trauma to the back of his head."
When she reached him his eyes were fixed and dilated. She removed the helmet, gave him oxygen and made sure he had a pulse.
An ambulance and helicopter arrived later. Emergency workers performed cardio-pulmonary resuscitation on Lloyd, but his injuries were too severe and he was airlifted to Vincent Pallotti hospital in Pinelands, where he was put on a life support system.
On Tuesday the system was switched off after Lloyd's mother, Helen, who lives in Morocco, flew in to see him. His organs were removed for possible donations and his father said he hoped it would be "a Christmas gift" to other children.
McPherson, who said he was feeling strong because of all the support he had received, was at the competition. "I was waiting at the finish line. When I heard about the accident I rushed to see my son. I supported his head while first aid was given to him. I could see Lloyd dying in my hands."
McPherson said his son, who had just finished Grade 7 at Camps Bay High School, started downhill skateboarding competitions about 18 months ago and that he had always been a thrill-seeker.
A memorial service will be held at 10am tomorrow at Llandudno Primary School. His ashes will later be scattered on Signal Hill, one of Lloyd's favourite skateboarding spots.
Tips for safe skateboarding
Skateboarding results in many injuries, says the Child Accident Prevention Foundation of Southern Africa.
"Learning how to fall safely can help reduce the risk of severe injuries," said foundation head Nelmarie du Toit.
The foundation recommends that skateboards should be used only by over-fives. It offers the following safety tips:
# Check the skateboard for wear and tear.
# Don't skate in crowds.
# Practise tricks in designated skateboarding areas only.
# Never skate in the road, in buildings or near water.
# Always wear protective gear.
Du Toit said learning how to fall could help reduce the chances of serious injury:
# If you are losing your balance, crouch down so you will not have so far to fall, or try to jump off as soon as possible.
# Try to land on the fleshy parts of your body.
# Try to roll rather than absorb the force with your arms.
# Even though it may be hard, try to relax your body in a fall, rather than stiffening up.
o This article was originally published on page 1 of Cape Argus on December 15, 2004
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head case
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On 12/15/2004 mikez
wrote in from
South Africa
(198.54.nnn.nnn)
Hey Doc,
My buddy Kent just crashed and hit his head pretty hard. He went in for a scan of sorts and came out diagnosed with a fractured skull and a blood clot on his brain. The doc said it would get better by itself and not to do stupid things. Now I'm not sure but I always thought that a blood clot anywhere near the brain was a huge huge thing. Please clear this up for me.
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Lloyd's story
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On 12/14/2004
Dr. Dave
wrote in from
United States
(24.13.nnn.nnn)
Freak accident leaves skateboarder brain dead
December 14 2004 at 03:09PM
By Arjan van Oosterhout
A 14-year-old city boy was declared brain dead after crashing in an international skateboarding competition.
Lloyd McPherson, from Llandudno, was racing downhill into a corner in the final of the competition near Betty's Bay on Sunday when he crashed. He hit his head, and the helmet cracked, causing severe head injuries.
He was declared brain dead at the scene, and taken to Groote Schuur Hospital.
'It was a freak accident'
His life support system was scheduled to be switched off on Tuesday after his mother's return from abroad.
"It was a freak accident," said his father Jan.
"Lloyd was wearing all the equipment that was required. Apparently the helmet he was wearing didn't work as it should have and went into his head."
McPherson said his son, who had just finished Grade 7 at Camp's Bay High School, had been a sports fanatic. It had been the first time he had reached the finals in an international skateboarding competition.
"He was very proud to have made it that far. He was a popular boy and had lots of friends."
Lloyd will be cremated on Thursday and his ashes will be scattered on Signal Hill, one of his favourite skateboarding spots.
This article was originally published on page 1 of Cape Argus on December 14, 2004
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Death of a Speedboarder
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On 12/14/2004
Dr. Dave
wrote in from
United States
(24.13.nnn.nnn)
People, check the speedboarding column. Lloyd died in a speedboarding contest, apparently of severe head injuries. His helmet may not have been adequate to the sport. Stop short on a longboard and you essentially hammer your head into the asphalt. Use the best helmet you can, preferably Snell rated and full face. While not every injury is preventable, we can do better to protect our own.
Dr. Dave
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Mark's Meat
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On 12/5/2004
Dr. Dave
wrote in from
United States
(67.163.nnn.nnn)
Mark,
You've got a lot of bones in your wrist, and probably jammed the joint somewhere. If it *really hurts, can't move the way it used to etc., get an x-ray; you may have a break or inflammation that is treatable. If it's just mildly sore and you and your doc are O.K. with NSAID's like Motrin, Aleve, etc., give that a try.
But it does take a while to heal if you've sprained or jammed it. Give it 6-12 weeks unless you've got that bad pain, limitation of movement etc. Then get that X-ray.
And finally. WRIST GUARDS!!!! It's incredibly easy to trash your wrists. The guards protect an area that needs protecting. As you now know. . .
Let us know what happens. Best of luck
drdh
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Skatestarr's CAT
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On 12/5/2004
Dr. Dave
wrote in from
United States
(67.163.nnn.nnn)
Too Old? The Good Guys who perfected longboarding are still out there and older than you. Search the list for the esteemed Mr. Coleman of Slide Fame and learn his survival technique. He's also older than you.
You are longboarding's First Generation. Nobody knows what's too old. I'd say, if you have osteoporosis, laminectomies, herniated discs or Alzheimer's, it's time to hang up the Dregs Supertanker. And f you insist on crashing, think about a full face helmet.
Hard to say if the ER "signs" merited a CT scan. But better an extra piece of film you can hang on your wall, then shoving you out the door with an undiagnosed intracranial bleed. Remember Patio Mendino's case a few years ago. He described falling, getting progressively worse day by day and was just sent away by his doc each time and given antibiotics for an "infection." He might have died if he hadn't ignored the doc's advice and gone to an ER. So safe is better than sorry. Much better.
Don't listen to the ER staff about being too old. Listen to your body, your brain and your spouse/significant other. They probably have better advice for you.
SK8ON SK8SAFE drdh
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head injury
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On 12/5/2004 herbn
wrote in from
United States
(152.163.nnn.nnn)
some people don't understand "risky" activitiesm, maybe they just ment you should have your head examined for skating at your agem,i profoundly disagree.
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Palm meat
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On 12/1/2004
Mark J
wrote in from
United States
(65.60.nnn.nnn)
Dr Dave
over a month ago, after running one step, i landed on my palms. it seemed
like all the meat in my palms got pushed into my wrists. it's been a month and
everything looks ok, but my palms still hurt. any idea what's going on in there?
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Chin music
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On 11/29/2004
skatestarr
wrote in from
United States
(199.46.nnn.nnn)
Hey Dr. Dave, the other day I was skating a new park and ate it right on my chest and chin (damn those wrist guards with the plastic inserts!). My chin was split pretty bad and bleeding so I went to the ER to get some stitches. After having everyone on staff tell me I'm too old to skate they stitched me up and told me they want to do a CAT scan because someone my age (41) should have the scan if they hit any part of their head. Isn't that a little overboard?
Thanks
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Above and Below the Neck
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On 11/23/2004
Dr. Dave
wrote in from
United States
(67.163.nnn.nnn)
Skatestar,
Hey, this forum is for anyone to Share Your Pain. Keep up the dialogue. I'll come in if it's my area, or if it gets too weird.
DRDH
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Sorry doc
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On 11/23/2004
skatestarr
wrote in from
United States
(199.46.nnn.nnn)
Sorry about the redirection Doc, I guess when we see Dr. we tend to generalize. But there was some good feedback from other skaters...
Steve
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