Mind games — Part III

Central doctor says athletes must be honest with their post-concussion symptoms

Matt Molloy mmolloy@ganderbeacon.ca
Published on May 15, 2012
SERIOUS ISSUE — Dr. Jared Butler of Killick Health Services in Grand Falls-Windsor speaks to a group of hockey minds at least year’s Hockey Newfoundland and Labrador AGM.
Beacon File Photo

During the peewee and midget provincial hockey tournaments in Glovertown and Gander, held April 9-11, two local hockey players suffered concussions. One was a result of excessive roughness, and the other was a result of a goal celebration. The Beacon will run a three-part series on the two athletes — Glovertown’s Abigail Hiscock and Gander’s Thomas Hedges — as well as their mothers, where the four talked about the injury, what happened moments after the injury occurred, and how the athletes are feeling today. For the third installment of the series, The Beacon spoke to a doctor about the symptoms the two athletes showed, and what they have to do to ensure a full recovery. This is Dr. Jared Butler’s story.

Dr. Jared Butler of Killick Health Services in Grand Falls-Windsor never treated Abigail Hiscock or Thomas Hedges for their concussions, but he’s no stranger to concussions, or post-concussion symptoms.

Dr. Butler was the medical director of the 2010 Newfoundland and Labrador Winter Games, and is the current medical director with the Grand Falls-Windsor Cataracts and medical liaison with Exploits Minor Hockey.

Last year, he gave a lengthy presentation at the Hockey Newfoundland and Labrador's AGM, where he informed members of HNL's Minor, Junior, Senior and Female Councils about the severity of concussions.

When told about Hiscock and Hedges, Dr. Butler wasn’t surprised to hear of their post-concussion symptoms.

However, when told they both suffered memory loss, he sounded a little more concerned.

“What you’re seeing there is amnesia, and amnesia is one of the more serious side-effects to see. Every time a patient comes to me and has had a loss of consciousness or a memory blackout, I am much more concerned about that athlete,” said Dr. Butler. “You tend to watch them a little more frequently. Amnesia is a concerning sign, but not an uncommon sign. The biggest things you have to worry about is loss of consciousness, the inability to regain it, and when you do regain consciousness, your memory should return, but it may not.”

During the first two parts of The Beacon’s concussion series, the local hockey players admitted to feeling better — though Hedges’ recovery seemed a little more progressive than Hiscock’s.

That’s not a concerning sign, and isn’t something that should scare Hiscock. According to Dr. Butler, concussions can have differing impacts on men and women. 

“Every individual is a different individual, and everybody’s recovery time is going to be different. When you look at Thomas versus Abigail, there are a number of different factors. There are a number of studies that suggest the impact on women is a little different than it is on men…and there are different recovery times associated with women and men,” said Dr. Butler. “Interestingly enough, there’s one study (out of the U.S.A.) that suggests women are more prone to concussions than men based on the nature of the sports they’re doing. Whether or not that translates to children is a different story. We don’t have a lot of data on the impact of concussions on children…the studies are mainly done at universities with university athletes. You do have some high school football studies from the States, but there’s very few data on children, and very little data on women under the age of 18.”

Hedges, when speaking to The Beacon, said he was back on the ice again, whereas Hiscock wasn’t allowed to participate in softball-themed Phys Ed classes at Glovertown Academy.

When told of this, Dr. Butler said it’s imperative that both athletes take extreme measures in ensuring they’re healthy enough to compete in sports once again.

“One concussion plus one concussion doesn’t equal two concussions — it equals five concussions,” said Dr. Butler. “Where the brains and neurological systems of children aren’t fully developed yet…damages from a concussion can impair some of these growth processes, and studies show this. I’m not saying Thomas or Abigail are brain damaged…but if they have repeated concussions, it can affect the growth and development of a child.”

“One concussion plus one concussion doesn’t equal two concussions — it equals five concussions.” Dr. Jared Butler

Baby steps to recovery

To ensure both athletes can safely compete again, Dr. Butler suggests they take things one day, one activity at a time.

For example, if Hedges or Hiscock can lay in a dark room for 24-48 hours without suffering from post-concussion symptoms, they can attempt reading a book, or watching a television show. If they can’t read a book without feeling a symptom, they need to stop reading for 24 hours, and try again 24 hours later.

If they can read a book, hang out with friends, and run around without suffering from post-concussion symptoms, they can begin their road back to the ice.

If they can skate without equipment, they can move on to skating with equipment. When they can do that symptom-free, they can move on to non-contact practice, and then full contact practice. If they can do all of this minus post-concussion symptoms, they’re ready to compete in a game.

However, recovery is hard, and Dr. Butler knows it’s even harder for a teenager or pre-teen.

“The hard part with kids is the treatment for a concussion will be complete bed rest and complete cognitive rest. When I say cognitive rest, what I’m talking about is putting a 16-year-old child in their bedroom with no TV, no books, no video games, no music, no cell phone, no iPad, no nothing, and they have to sit there in the darkness for 24-48 hours until they can reevaluate their symptoms,” said Dr. Butler. “This can go on for a long time…so how do you tell a child at that age to not go to school, or to not play with their friends? Recovery is so hard for children at that age.”

Now that they’re on their way back to recovery, Dr. Butler had one massive piece of advice for the athletes.

Be true to yourself, and be truthful to those who are keeping an eye on your post-concussion symptoms.

Time and time again, Dr. Butler has seen athletes lie about their symptoms, which only leads to worst side-effects, and an unhealthier future.

“You have to be honest about it. If you, for example, ignore a headache, and you continue to have a headache during an activity, you’re prolonging your concussion-like symptoms,” said Dr. Butler. “I can name numerous athletes this has happened to, and I can name numerous local athletes this has happened to…so it’s a very serious thing, and it’s very common.”