School Sports and Concussion

If you are a parent of a student athlete, this back-to-school reminder is for you.

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As school athletic teams gear up for fall and winter, it’s time to think about concussions: how to prevent them and what to do when they happen. Every parent, coach, and school official should make this part of their back-to-school routine.

When sports-related concussion is mentioned, most people immediately think of boys’ football or ice hockey. But while these sports produce the highest rate of concussion, girls are also at risk.

As reported last year by The Atlantic, Olivia Hayward, a 90-pound high school varsity soccer player, got knocked to the ground. At first, she worried about her injured wrist. But a few days later, she had no appetite, was bothered by light, and had a throbbing headache. She failed the simple test for concussion that her coach had her take. Her doctor finally determined that she had suffered whiplash and a concussion, her second. She missed 3 weeks of school, and her parents had to read her assignments to her. And she was among the lucky ones.

Concussion Suspected?

When student athletes display or report symptoms associated with concussion, most coaches remove them from play until a medical professional has conducted an examination. The general rule is, “When in doubt, sit them out.” Follow-up for a few days or weeks by a licensed health care provider is often recommended. Nearly all states require these measures by law.

Most children and teens will be able to return gradually to school and sports activities. Sometimes after severe or repeated concussion, support services are needed. Because a concussion is a bruising of the brain, it can affect learning and mood. Teachers might need to tailor assignments and exams to accommodate concussed students. School officials, teachers, educational specialists, school nurses, coaches, and parents should work together as a team to make sure that a student’s returning to school and/or sports activities occurs smoothly and is monitored.

Bottom line: Whenever you suspect a student athlete has suffered a concussion, have a licensed health care provider (physician or physician assistant) evaluate the situation.

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Important resource: The Centers for Disease Prevention and Control (CDC) provides much useful information, including several videos, for parents, athletes, coaches, teachers, school officials, health providers, and others about sports-related concussion. Become informed and get involved!

Reducing Risk of Concussion

Risk of concussion varies by sport and, to some extent, by sex (girls might be at greater risk than boys in sports played by both). The following measures can reduce risk.

  • Athletes must wear protective equipment that is in good condition and appropriate for each activity. Be sure that it fits. (Remember: a person can still have a concussion even if wearing a helmet.)
  • Make sure that coaches limit hard physical contact especially during practice.
  • Check with school officials that their policies and procedures regarding concussion—both prevention and concussive events—reflect best practice and not just state law.
  • Ensure that your son or daughter understands the importance of following safety rules, and tell them to let you know if they have suffered any blow to the head during their sports activity.
  • Join others in making sure that state law, education regulations, and athletic rules incorporate the recommendations of experts in traumatic brain injury and its prevention.

A Final Word

Concussion is one form of traumatic brain injury that is widespread and serious. At Kathy’s Urgent Care, we evaluate one to two patients per week for concussion from all sources (falls, vehicle accidents, workplace injuries, sports activities, etc.).

For more information about symptoms and other aspects of traumatic brain injury, please see our previous blog post on this topic.

5 Urgent Care Myths Debunked

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Have you noticed? Delivery of health care services is changing! When trying get the health care you deserve, when you need it, and at affordable cost, you might be confused by all the options, including urgent care. Myths about urgent care have gone viral, preventing many folks from choosing the best alternative. As you decide what’s best for you and your family, don’t be hoodwinked by these common misunderstandings.

Myth #1. Urgent Care and Emergency Room Care Are the Same

While it is true that urgent care centers and hospital emergency departments both treat acute or urgent injuries and illnesses, persons who suffer from a truly life-threatening condition should go to an emergency room or call 911.

Urgent care centers treat most non-life-threatening injuries and illnesses, including broken bones, sprains, cuts, strep throat, bronchitis, allergic reactions, eye and ear infections, low back pain, headaches, nausea, and many more. Waiting times are nearly always shorter and cost is lower than with ERs.

The following chart of symptoms can help you decide where to get the most appropriate care.

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Myth #2. Urgent Care Staff Are Less Qualified

Be assured that all clinical staff at urgent care centers receive the same training as clinical staff in hospitals and family practices. A supervising physician is always present or on call. Other providers such as physician assistants (PAs), advanced practice registered nurses (APRNs), and medical assistants (MAs) must be credentialed and licensed according to state law.

Some urgent care centers also provide specialized clinical services such as orthopedic or pediatric care. When necessary, urgent care centers will refer patients to an appropriate specialist and will often arrange an appointment for a patient more quickly.

Myth #3. Urgent Care Costs More

In nearly all cases, treatment at an urgent care center costs less than at other locations. Because emergency departments must cover high overhead costs for sophisticated equipment and 24-hour staff, charges for ER treatment can be very high. This can be a problem especially if your health insurance plan carries a high deductible amount.

Urgent care centers accept most insurance coverage. Even if your plan carries a high deductible, your insurance will generally lower your out-of-pocket cost. If you have no insurance or choose not to use it, your urgent care center will usually charge a modest flat fee for treatment.

Bottom line: Urgent care fees are nearly always lower than emergency department or family practice fees.

Myth #4. Urgent Care Centers Only Treat Minor Ailments

While urgent care centers do treat minor ailments, the term “urgent care” can be misleading. Most urgent care centers also offer preventative health care such as screenings for disease, general physical examinations, and vaccinations (flu, MMR, Hepatitis, Tetanus, Diphtheria, Pertussis, Pneumonia, Polio, etc.).

Physical exams are offered for immigration, employment (DOT/CDL exams, drug testing, etc.), and school or sports requirements.  They also provide testing and treatment for STDs.

Urgent care centers usually have X-ray equipment and laboratories on site and can dispense routine medications.

Myth #5. Urgent Care Centers Don’t Interact with Other Health Care Providers

If you are concerned that your primary care physician won’t be informed about your urgent care visit, relax. Urgent care providers communicate regularly with family physicians, specialists, and hospitals. A complete record of your visit will be available to other providers as needed.

If there is any question about the nature of your care, the urgent care provider can contact your regular physician or specialist for consultation.

You can also rest assured that your health care privacy will be protected as required by federal and state law. Only other providers and your health insurance carrier(s) will have access to your records if necessary and as authorized by you.

Video Discussion

We are now posting live video discussions of important health care topics on Facebook and YouTube. To learn more about urgent care from Dr. Thomas Brown, check out the recent video on Facebook in which he announces the opening of a third Kathy’s Urgent Care clinic in Berlin, Connecticut. Learn why urgent care is expanding and how it can serve you and your family.

Why Are You Sleepy?

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Do you wake up feeling tired? Have a strong urge to sleep during the day? Become drowsy while driving? Fall asleep while watching TV or a movie? Snore? Does your snoring keep your partner awake? Do you suddenly wake up during the night gasping for air or with a dry mouth?

If you answer “yes” to any of these questions, you might have “obstructive sleep apnea” or OSA. This is a condition in which your airway becomes obstructed during sleep causing you to stop breathing normally. Because this happens while you sleep, you probably don’t know that you have OSA at all.

What Is Obstructive Sleep Apnea (OSA)?

OSA occurs when your muscles relax and allow the soft palate and tongue to close off your airway. This causes you to stop breathing several times during the night for up to 10 seconds or longer and produces a drop in the supply of oxygen to your brain. This cycle can be repeated 30 times or more each hour, all night. No wonder you wake up tired!

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OSA is serious and, if untreated, can lead to high blood pressure, diabetes, obesity, depression, lack of sexual desire, heart disease, heart attack, dementia, or even stroke. OSA deprivers you of deep, restorative sleep (commonly referred to as REM or “rapid eye movement” sleep) so necessary for good health.

Symptoms of OSA

Symptoms of OSA range from chronic fatigue or sleepiness during the day to snoring and consciously disrupted sleep at night. Common symptoms include

·      Feeling tired or exhausted upon awaking in the morning

·      Frequent drowsiness when engaged in normal activity during the day (driving while drowsy is a major cause of traffic accidents)

·      Depression or changes in mood during the day

·      Loud and frequent snoring that sometimes awakens your partner

·      Waking up while gasping for breath or choking

·      Dry mouth or morning headache

OSA is also associated with high blood pressure, lower sex drive, and weight gain.

Men suffer from OSA at 2 to 3 times the rate for women. Persons who are 30 or more pounds overweight or who have thick necks (17 inches or more in circumference) are susceptible to OSA because being overweight enlarges the soft tissue in the back of the throat.

OSA can afflict persons of any age, but it usually peaks between ages 40 and 60. Smokers experience sleep apnea at 3 times the rate for non-smokers.

A large majority of persons are unaware of having OSA and do not seek treatment for it. The cost to society of not treating OSA is significant since it results in traffic accidents, stroke, and heart attacks. That’s why truck drivers and others who need a commercial driver’s license are required to be screened and treated for OSA.

What Should You Do?

If you have trouble sleeping or have any of the above symptoms, you should be checked by your health care provider. At Kathy’s Urgent Care, we can help determine an appropriate course of action to cope with your individual situation.

Above all, do not self-medicate with alcohol or sleeping pills. Alcohol relaxes the muscles that control the soft tissue around your throat, making your problem worse. And most sleeping pills contain muscle relaxants that have the same effect. Using either will likely make your problem worse.

Depending on how severe your problem appears, we can recommend at-home testing kits or refer you to a sleep testing facility as needed. The home kits cost about $250, and some vendors accept insurance payment. Sleep testing facilities are more expensive and are usually covered, at least partially, by health insurance plans. Either route can give us the information needed to follow up.

While you might need assistive measures—CPAP or EPAP devices, dental appliances, etc.—quite often you can achieve good results simply by losing weight. Losing weight often controls snoring and can reduce or eliminate sleep apnea over time. Doing so, however, takes a while and can be difficult to achieve. We have learned that medically supervised weight control programs and changes in lifestyle are most effective in achieving permanent improvement. In most cases, surgery should be considered a last resort.

OSA can lead to very serious health issues and even cause death. Get checked by your health care provider and decide on a weight loss program or other measures to relieve your symptoms. Don’t put this off!

Remember that at Kathy’s Urgent Care, we can help with this and related health problems.

If you’ve had experience with OSA and various treatment options or if you have questions or opinions about OSA, please leave a comment below.