ReThinking Concussions: Hosted by Hannah Storm

ReThinking Concussions: Hosted by Hannah Storm

Up to 3.8 million sports- and recreation-related concussions happen every year. It’s estimated that up to 40 percent of concussions go unreported or undetected.

Not only are no two concussions alike, but the experience of concussion is different for every individual. In this video, you will hear from a number of UPMC patients and their families as they discuss their personal concussion experiences with ESPN’s Hannah Storm. One of the patients is Dale Earnhardt Jr., who chose UPMC for concussion care in 2012 and 2016.

 

Read the Full Transcript from ReThinking Concussions: With Hannah Storm and Dale Earnhardt Jr.

Hannah Storm
Hi everybody and welcome to this Facebook Live chat, with UPMC, I’m Hannah Storm of ESPN Sports Center, we have a fantastic panel for you today. We’re going to learn a lot about concussions. We’re going to learn a lot about concussion recovery, all the latest information from the very, very best in the world. Now, I want to introduce you to our panel, and our foremost expert, and yet there he is, looking very official, Dr. Micky Collins. So, if you could just wave right there, Dr. Collins. And then you probably recognize the guy sitting next to him, and that is superstar Dale Earnhardt Jr., just one of the foremost athletes of our time, who has suffered concussions and managed to continue his wonderful career and even win a Daytona 500. He’s going to tell you his story after that. And then this beautiful young lady next to him, that is Madison Mansmann, she is a competitive gymnast, specializing in the beam and the bars. And that is her proud papa Eric, right next to her. Eric, come on, give a wave to the folks at home. All right, next to Eric is Missy Matthews, she works right next door. So, it’s great to have her with us this morning. Missy is the face of Steelers.com, and she also has suffered a concussion. She’s going to tell us about it. And right there in the back is a guy we’re going to be hearing a lot about in the coming years, it’s Jack Young. He’s the star receiver at Mt. Lebanon High School; he’s going to go play for The University of Michigan, Yeah! Next year, and he’s going to share his story, and his mom, Lillian, is there as well. And then, last but very not least, is Jillian Andrews, she is in digital advertising. She was working in Pittsburgh. She now lives in Washington, D.C., and she also has a great story. I’ve learned so much, just in the run up to this, I had a concussion myself a couple of years ago. It’s unlike any of the other stories you’ll hear, but I think that Missy being in the media will really appreciate it. I had a camera operator take a jig camera, which is a big swinging camera, in the studio, and he swung it right at my head, and down I went. So, I actually got injured at work by a camera and I wish I would have known the folks at UPMC, and known about concussion recovery at the times that have very, very difficult recovery after that. So, thrilled to be here, let’s start with you Dale, and kind of give folks a little bit of your story which dates back to when we were talking about this earlier, all the way back to 2012.

Dale Earnhardt Jr.
Yeah, I had an accident in 2012, at Kansas in a test, and I had a concussion immediately after that event for the next several days, actually for the next three or four weeks. I decided to keep driving, and keep racing, and didn’t seek any help. I was involved in another accident four weeks later that doubled my issues and made the symptoms much worse. And that kind of scared me straight to the doctor, and luckily for me, the guys that I went to see in Charlotte, lined me up with Micky. So, that was sort of a stroke of luck for me, because of how strong Micky’s team is. But, we spent several weeks working to get ourselves healthy. We were back in the car in a couple of weeks, and racing to finish the season. And then we went on and won the Daytona 500, and several other races over the next couple of years. Had a lot of great success. And last year in 2016, we were involved in several accidents, and in this situation it was kind of new. I didn’t know immediately after the accident, the final accident that I had a concussion. This came on very slow. It was really delayed by several weeks. So, I felt, I didn’t think it was a concussion at first because it came on kind of like allergies, or what have you. But anyways we got back in front of the doctors and got diagnosed, and understand that it was an issue from repeated crashes that I had had throughout the 2016 year, and the symptoms had gotten quite severe. So, I was really lucky and fortunate again to get back in touch with Micky and his team. And with what they’ve learned since 2012, the treatment that I saw this particular time, was even more robust and much more, and necessary because I was in a pretty serious situation. But, they got me straightened out and I got married in off season. Which was great. And I was healthy and clear. And able to enjoy that experience. And now I’m back in the car for the 2017 season, having the time of my life.

Hannah Storm
Well, that’s an incredible story and when you talk about the struggles, you used the word serious. So, could you share with us what you were feeling? What was happening physically and mentally, as result of those concussions?

Dale Earnhardt Jr.
The symptoms that I had when I went to see Micky in 2016 were my vision sort of bounced around; anything like taking a step or any kind of vibration would shake my vision off any object or target. So, I could ride in a car down the street, everything outside the car was just crazy shaking really bad, and I couldn’t read road signs or anything. So, I just kind of had to stare at the floorboard anywhere that I went. Accompanied with that I had a lot of balance issues. I couldn’t turn corners without losing my balance; I couldn’t go into dark rooms or hallways without losing my reference of what was level. And I would lose a lot of understanding of what was upright and what was down, and darker environments were very challenging for me. And very busy environments, going into a grocery store would multiply the symptoms. And going to anywhere busy like a mall, a grocery store, sporting event… that would really bring out the worst. So, those were the kind of things that we were dealing with.

Hannah Storm
And what you say is not that unusual, I know from just personal experience. Months after I had my concussion, I had vestibular balance problems, and that resulted in a fall down the stairs and a busted tail bone, and I also broke an ankle. Because I, like you, couldn’t really assess what was level, or when you start to lose your balance, you can’t self-correct like you normally do. And so Dr. Collins, what Dale was talking about, much less getting back into a race car, continuing his career, but his quality of life was in jeopardy. So, what advances have you made? You know, Dale talked about how you were able to make more advances over the last four years, to help him get back to normal. What are some of those?

Micky Collins, PhD
Hey Hannah, we’ve really made tremendous progress in how we understand this injury. And when I first saw Dale, the conversation wasn’t, I want to get back in a race car; it was I just want to live a normal life. And Dale was not feeling well. And you know, so we didn’t even really talk about racing initially, it was just getting Dale the right therapies he needed to get better. And as a treatment team, we were confident we would be able to do that. Our treatments have advanced to the point now where we understand there are different types of concussions. There are actually six different clinical profiles that we see for this injury. And we’re starting to match different treatments to those different profiles. And as the years go on we get better and better at doing that. And Dale’s problems were primarily related to ocular motor dysfunction. With concussions, the eyes don’t work together as well as they did, and there can be a decompensation in that system, and that combined with the vestibular system, which stabilizes our vision when we move our head, and allows us to interpret busy environments, and you know, as a human being, let alone as a racecar driver, when you have that happen, it produces very distressing symptoms. And I don’t even think Dale thought he would find a way out of it because it’s so distressing. And it sounds like you went through some similar things. But, with the advancements we’ve made we can rehabilitate those systems and, an important point here, is that you actually have to retrain those systems; it’s not rest that takes care of that. And, so active treatments for concussion need to replace the more passive approach that we’ve taken in the past.

Hannah Storm
Yeah, okay. I want to continue, sort of on the theme of what you said, and just so people understand, you know, what happens when they come to UPMC. It’s that they are evaluated by your team as to the specifics of their concussion, and you’re tailoring the treatment program for them, whether they go back home, or if they’re lucky enough to live near you they can get the treatment with you there. So, I want to, because Dale’s example is so extreme, and he’s an elite athlete obviously, you can be concussed at any age, and in any way. And, so I just want to go to Madison for a moment. So, Madison, you’re 11 years old, and certainly concussions are different at different ages, tell us how you experienced your concussion.

Madison Mansmann
I was in a car accident, and we were sitting still, and a car came 55 miles per hour and hit us from the back. And then our, the back of our car was up off the ground.

Erik Mansmann
We had her to the pediatrician and were just following a normal course of treatment, and she was seeing no progress. And, my son had seen Dr. Collins previously for a concussion, and I told my wife, we’re going to see Dr. Collins. Got to see Dr. Collins and to diagnose what was going on with Matty, it was vestibular, it was exertion, and one of the things that was different that we really liked, that I think was really good for Madison, was that she was an active participant in her therapy. You know, she was able to push herself; she was able to continue doing her gymnastics, to whatever level she could. When she was going through her vestibular therapy, they would you know, find the point where she could go to, and safely practice, and still practice. And I think that helped her more mentally, along with the symptoms of the concussion because she took it pretty hard when it was taken away from her. And you know, unfortunately when you look at an 11 year old child and she does something 20 hours a week, and that’s how they identify themselves. So, she was able to really dig into it herself. And work at it at home, and work at it at the therapy that she was going to. And we’re lucky to be in Pittsburgh. So, we could go to a variety of many of the UPMC facilities. To just match into the schedule and just, it worked out great. And she’s here today, she’s done, she’s competing again, it happened in September. And she got released finally; Dr. Collins was a little reluctant, because there was still a little bit there. And he held her back and it was good that he did. Had his finger on the pulse of what was going on. And she competed in three meets since then. Qualified for States, and participated in Pennsylvania State competition last weekend. So, good stuff.

Hannah Storm
Just great job. The message here is that there’s hope, right? Because it’s so scary. You look at things you love to do and not being able to do those, and not even be able to function, to do the normal things. So, Madison, as the youngest person here today, what do you want people to understand, in terms of young people and concussion, and what they need to know?

Madison Mansmann
Well, it’s kind of a hard thing to go through because I wasn’t really doing what I wanted to do at that time. And you have to work really hard to get back. And I got back to what I was doing.

Hannah Storm
That’s wonderful; let me go over to Missi. So, Missi, what is, obviously you didn’t get head mic’d like I did. But, you’re active; you’re out there riding your bike as I understand, what happened?

Missi Matthews
Yeah, there’s beautiful trails all throughout Pittsburgh, it was last April, I’m almost at the year where I actually had my concussion point, was with my husband, my son, some family friends, we were all having a good time. I made the mistake of not bringing my helmet with me after we parked the car. There were too many people on the trail. Somebody didn’t move. I was the person who unfortunately completely veered off, I don’t remember falling but I remember seeing that it was coming. I was badly bruised and cut up all over my body, but instantly, everybody knew that was with me that something was wrong with my head. I didn’t remember falling. I’m looking at the river like where are we? So, luckily Dr. Collins’ team, Dr. French was my doctor, they’re right next door to where I work so, I started going there. A lot of it for me was, I never had a baseline test, or an impact test, and I never dealt with a concussion. I’ve never had headaches. And not being able to do normal things. My son was one at the time. His toys drove me crazy. The lights, the noises, the colors. I wasn’t able to read. And, I was just mad at myself, you know? You tell yourself wear your helmet, be smart, football players know this, gymnasts know what they need to do to be careful. I should have had my helmet on. So, a lot of it was the self-guilt I think. And realizing that I needed to push myself to try to get better. To just live the normal life, not so much getting back on a bike, which by the way eventually I did get back on my bike a few months ago, which is good. Yeah, it was just really hard. And I had a setback, so I had to end up doing some therapy. But, just being able to operate. It was very difficult. But, I’ve learned a lot through the process. The players that I cover on a daily basis deal with concussions. I’ve learned so much about what they go through, and just the impact test and what it takes, and how much they know about our brain it was a remarkable experience in terms of learning. I wish it never happened, and I will always wear a helmet now.

Hannah Storm
But, I want to say that it is a common myth, Dr. Collins right, that helmets can prevent concussions when they can’t? So, that is something that I learned in my research for this segment. But, what do you, from her case, from Missi’s case, what do you think is the most interesting thing to share with our viewers?

Micky Collins, PhD
She’s a mom. And has a one year old child that she can’t, I mean, there’s a lot of overstimulation that can happen when you’re concussed, and that’s what resonated with me immediately was you’re a mom. And it affects a lot of different things in people, it takes people out of the sports they love, you know school difficulties in your situation. But, I think, flipping the script here is that this is a treatable condition. And we have ways of rehabbing it, and I think you went through that. And I think it’s so critical to take an active approach to this, and to proscribe the right treatment for the right problem, and change the conversation. Because I think there’s a lot of misinformation out there about concussion right now, and to say it’s a treatable injury which it is, I think really changes things dramatically as to people’s perceptions. Just making sure that people are aware that there’s help out there to get better.

Hannah Storm
And I think there’s hope. And we do associate concussions often with certain sports. I love the diversity of this panel, because we’ve seen that really anyone at any time can suffer a concussion. But, of course, Jack, something that you see a lot in the sport of football, so can you take us through, what was your experience, Jack?

Jack Young
We were playing Bethel Park for the Championship game, I remember this was the first game I had to play defense and I never played defense because I don’t like hitting people. Just because of this reason. But, I remember there was a play, and the running back was coming off the edge. And I saw him, someone hit him. But, I lead with my head, which you’re not supposed to do obviously. And I remember when I hit him I could feel it coming from my body. And I didn’t remember up to that point. It was kind of scary. And we had just gotten the ball and it was, he had fumbled, and he was calling the play. The coach was, and I lined up wrong. They had to call time out, because I didn’t know what I was doing and stuff. They asked me if I was okay and I was just like yeah, I obviously couldn’t remember what was going on. And so that was obviously really scary for me, just that part of it, and just the weeks afterwards. When I was getting rehabilitated, just little things like not remembering fragments of a conversation or something like that. That’s kind of more my experience with the vestibular stuff, but I’d work on that. Reading was very difficult with me, staying focused. I feel like I’d always start daydreaming in class or something like that. So, I’d work on those a lot in my rehabilitation.

Hannah Storm
And that’s really scary too because obviously academically, in the classroom, you’re trying to keep your grades up. You don’t want to fall behind, right? You’re looking at colleges.

Jack Young
Exactly.

Hannah Storm
And Lillian, as a mom, watching this go on, what was that experience like for you?

Lillian Young
I knew it as soon as he took the hit, because I could see it happen. We’re lucky because we have UPMC physicians on the sidelines, and we have UPMC’s concussion clinic, seven or eight o’clock on Saturday mornings. And I got the call from his trainer on my way home after the game that he needed to go to the clinic, so it’s scary sitting there in the waiting room, until you understand there are lots of different concussions. You know, Dale had very, very severe symptoms that lasted for a long time, you know, you don’t know if it’s something they can work through, in a short time. Or if it’s going to affect him and his grades or playing football. Because, it’s very important to him, for college, that he is able to play, and that his grades stay up. And you know, he’s irritable anyway and so it just made it worse. But we’re so lucky to live in a city where we have these resources right in our back yard. And you know, they took great care of him. They made sure that he was healthy before he went back in and played, because taking another hit before he was ready could really, really sideline him, so you know, we’re very grateful.

Hannah Storm
Dr. Collins, can you talk about that? A little bit about what Lillian was saying about being able to get back and engage in activities that you were doing before, but the ability to recover all the way is quite important for these kinds of injuries?

Micky Collins, PhD
Yeah, we’ve just published a study, the immediate removal from play is critical to outcomes. And, I’ll save you the details, but we’ve found that players that continue to play through an injury, even 20 minutes after the first symptoms of concussion, it can double their recovery time. So, it’s very important that this is recognized by parents, coaches, etc., and the patient is taken out of play. And then they need to get to a specialty clinic that can diagnose actually what is occurring and what type of concussion they have, and then match the right treatment to that problem. As I stated, we have very active approaches now to treatment. And hearing Jack talk, yeah, he’s a student. An academic kid first and foremost, and you know it sounds like he had an ocular problem, which is going to have a difficult time focusing on his math and science, and if that’s not addressed, his grades are going to drop. And even though you’re going to the University of Michigan, I went to Michigan State, so the standards are a little lower, at Michigan.

Hannah Storm
I went to Notre Dame, Doctor, okay, so… We’re all friends today.

Micky Collins, PhD
Yeah, but anyway, no, but his injury was totally different than Dale’s injury, listening to it. And different from Madison’s injury and that’s the issue is that there is so much variability. You’ve got to get your pulse on what’s happening and do the right treatment.

Hannah Storm
And, so it’s got to be treated, again it’s got to be matched to the type of concussion so initially, that’s why the evaluation is so critical. Right? Stopping what you’re doing, even though, you know, as Dale mentioned, sometimes you don’t even know you’re suffering from a concussion. It can take a while. So, as time goes on Dr. Collins, is it harder to treat the longer you let a concussion go?

Micky Collins, PhD
Yes. No question. And the earlier we see someone from it the better the prognosis, so yeah, get him in, get him evaluated, and get the right treatment plan in place.

Hannah Storm
Okay, now she’s been waiting patiently to tell her story. Jillian, how did you get concussed? What happened to you?

Jillian Andrews
My concussion happened when I was in high school; I was a forward on my school’s basketball team, so we were in the middle of a big game. I was under the net and a girl from the other team came down from a rebound and I took an elbow to my temple, which sounds really bad, but I initially felt completely fine. I continued playing through the rest of the game, and even in the hours after I felt completely fine. I thought I was fine.

Hannah Storm
You don’t know.

Jillian Andrews
Right.

Hannah Storm
You don’t know at the time right?

Jillian Andrews
Yeah, absolutely. And I just wanted to finish the game. I wanted to help my team. But that night and the following couple of days it became very obvious to everyone around me that something wasn’t right. I was having memory problems. I was having severe headaches. So, I went to see my family doctor who diagnosed me with a concussion, I sat out from play for a couple weeks, and then it was my first week back to practice and games, where I think I reinjured myself in a game. And that’s how I found my way to Micky and UPMC for an additional evaluation and the next steps to recovery.

Hannah Storm
So, what kind of treatment did you receive? What did you do to recover?

Jillian Andrews
I had post concussive migraine syndrome, which I’m sure Micky can talk a lot more about. So, the first step was addressing my migraines. I had them every day and they were pretty severe, I was very sensitive to light and noise, which really impacted me at school. So, I had a lot of school modifications. A lot of help in classes. You know, I wasn’t in the lunchroom. I wasn’t around my friends. And then from there it was kind of a very slow return to play.

Hannah Storm
That’s so tough too emotionally I think. That’s something that we probably don’t address enough about concussions too, because it takes you away from the things you love, sometimes the people you love. And you’re confused, and upset that, you know, Dr. Collins, I mean that’s a whole other layer, besides the physical right? The emotional impact of these injuries?

Micky Collins, PhD
Yeah, I’d like to comment on that actually. We actually see emotional issues arise physiologically because of the concussion. So, biologically, anxiety is a symptom of concussion, and then it can actually interfere with patients getting better. It can condition them not to do the things they want to do. It can really take you down a rabbit hole pretty quickly. And that’s where we find a lot of patients that don’t get managed right. So, yeah the emotional part of it is something that you have to recognize as a clinician, and you got to be able to hit that head on.

Hannah Storm
Also, just listening to some of the people on our panel, Dr. Collins, who have suffered multiple concussions, and you know, it’s interesting to hear Jillian say that she went back and then she was concussed again, can you talk about recovery and the cumulative damage that concussions can do? And what you found out about recovery, and how you can sort of abate those symptoms from getting worse?

Micky Collins, PhD
Yeah, I would actually state that a well-managed concussion is the best form of prevention and we actually don’t see cumulative effects of injury, if it’s managed effectively. It’s just when you’re not getting it treated and you keep getting re-concussed and less force causes those problems to come on. That’s when we really see the problem, so, you know, that’s why awareness is so critical. And understanding the symptoms, but yeah, if you treat it fully, we don’t necessarily see increased risk for recurrent injury. We’re actually learning that there’s certain risk factors that make people more at risk to have more concussions, like a history of motion sickness, or a history of lazy eye, or a history of migraine, a history of anxiety , being female versus male. There are certain risk factors that lead people to have more concussions, but it’s not because you have one concussion it makes you more vulnerable to another if it’s managed correctly.

Hannah Storm
Dale, you’ve sat there and listened to all of these stories, and they’ve each been fascinating in their own way, if you could share with somebody at home who might be watching this, you know, somebody that’s really, really struggling right now, what would you want them to know from your experience?

Dale Earnhardt Jr.
The one thing that’s going to help is being transparent, talking to your doctor, and being honest with what you’re feeling, I guess, you know, in sports, competitors, a lot of times we tend to want to mask our feelings or injuries and that’s a real dangerous thing to do particularly with your brain. And being transparent and clear and telling your doctor what’s happening and what you’re feeling, it’s such a hard injury to diagnose and visually see and get your hands around, and so you’re really going to help the doctor if you can tell them what you’re feeling and what you’re experiencing. They can understand by just your words alone, kind of what direction to go and where to look for where to target the injury and also how to treat it. So, a lot of people may assume that you just go in, and Micky’s going to run some tests and find it and know how to fix it. Well, that’s half of the game. The other half is really, you, yourself as a patient being really forthcoming and honest about what happened to you and what you’re feeling. So, that’s really critical, and something that I think is important, if we get people feeling that way, and acting that way, I think we change the culture and not only how, we’re already changing the culture a little bit, in society, but I think that once we get people to be more honest about what’s going on with them, and not to hide their concussions, or try to play through them. That’s so critical because as you see in some of the cases here, mine included, when you layer the concussions is when you get into the most dangerous situation.

Hannah Storm
I’m glad that you are speaking about it because there is a culture, and you have some athletes on the panel with you, where toughness of not wanting to talk about it, and not wanting to address it. So, by coming forward and being a public figure you can make a big difference. And Dr. Collins, how important is it to be specific with your doctor, in other words so, to pay attention to what is happening in your life? And maybe it hasn’t been diagnosed properly, or you haven’t treated it properly, but, just self-advocate as a patient.

Micky Collins, PhD
I mean the transparency, I sit down and talk to a patient, and we really understand, if we can listen to what symptoms they’re experiencing in what environments, with what risk factors, with our test findings, it just makes all the difference in the world, as to, we can understand what is going on and then apply the right treatment to it. And, that’s what Dale did, and what Madison did, and you know, it’s very important to understand this is a highly variable injury. It’s not going to present the same way every time. It’s going to present differently for different people.

Hannah Storm
Your story is going to be different from everybody else’s, just like our panel here today. But the great news is that you guys at UPMC have figured out that this is an individual injury and how to treat it case by case. So, I really applaud you. Thank you all for sharing your stories. I’m sorry I had to be here, really because of really bad weather problems, that I had to be here in New York, but you know, sending all my support and appreciation to those of you in Pittsburgh. And just like the folks at UPMC, right? We figured out a way to get it done.

Micky Collins, PhD
Thanks Hannah.

Hannah Storm
You have to have obstacles so you can figure out how to push through.

Micky Collins, PhD
Thank you so much.

Hannah Storm
Did you want to say something else, Dr. Collins?

Micky Collins, PhD
No, thank you to yourself and the rest of the panel. Really appreciate you guys coming in today, and sharing these experiences, thank you.

Hannah Storm
So, Dale, good luck on the track. And Madison, on the beam and the bars. And Missi, we look forward to seeing you report on a winning season with the Steelers. Please bring us good news there. Jack, I mean listen, go Wolverines, what can I say? We are all going to be cheering for you, even me. Except for if you play Notre Dame, and Jillian we wish you all the health, too. And, to our mom and dad that are here today, God bless you for having such great kids. So, everybody thanks for joining us. Go to this Facebook page with your questions and the great folks at UPMC are going to answer your questions throughout the day, they’ll be checking Facebook for any questions or comments or anything that you might have. So, thanks again everybody for offering a lot of hope, to folks that are suffering from this injury. And to continuing all the great research that you’re doing, thanks everybody, bye bye.

 

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