'I Thought I Understood Everything About Concussions Until It Happened to My Daughter'

As the fast and hard-hit volleyball slammed against my 15-year-old daughter Olivia’s head with striking force, parents from both teams shot up from their seats and gasped—including my wife and me.

The cheering that filled the gym went silent.

As the volleyball was spiked, it had ricocheted off of Olivia’s head and into the air. The momentum of the play continued as her teammate passed the ball back to her. Olivia hit the ball over the net.  My worry quickly turned to relief because she wasn’t knocked out and she didn’t drop to the floor, so I was sure she was okay. But later, I learned from Cleveland Clinic doctors that it isn't unusual to retain consciousness and even be symptom-free at the beginning stages of a concussion.

“While concussion symptoms can appear quickly or within hours, it’s not uncommon for symptoms to be delayed by 24 to 72 hours:” Dr. Marie Schaefer, MD, who specializes in pediatric concussions at the Cleveland Sports Medicine Institute, told me.

What the Aftermath of Olivia's Injury Looked Like

On the ride home from the tournament, Olivia said she felt good. A little tired, but that's not unusual after a tournament, and she wanted to eat. I figured that must be a good sign because she didn’t vomit right away, but Dr. Schaefer pointed out that only about 50 percent of concussion patients vomit.

By the time we drove our daughter the one-hour drive home, she just wanted to lie down. I thought maybe I shouldn’t let her fall asleep until we saw how she was doing. Lo and behold, a few hours later, Olivia had a headache. She was very tired, and now she was squinting because the lights made her eyes uncomfortable. Just to be on the safe side, my wife and I took her right to the Cleveland Clinic emergency room to get her checked out.

After a thorough exam, the doctors diagnosed her with a concussion. They told us to keep an eye on her for worsening symptoms, which could mean an MRI of the brain might be needed. They told us it was okay for our daughter to go home, but to follow up with doctors in their Sports Medicine Institute the next day.

By morning, about 12 hours after the ball caromed off Olivia’s head with such force, we drove her to the doctor’s appointment while she kept her coat over her eyes due to increased sensitivity to sunlight. She was now lightheaded and very tired.

In the coming days, she was struggling to focus. My wife and I were hoping to see quick improvement like when your child has a fever and they can go from lethargic to having more energy when the fever breaks. But that wasn't the case: Her recovery was slow and tedious.

Related: The #1 Worst Food for Brain Health

'A Concussion Is a Brain Bruise'

Dr. Schaefer explained the mechanism of a concussion to me this way: “A concussion is a brain bruise that causes disruptions to nerves in the brain and that’s why patients with concussions can experience sporadic short-term memory loss which will slowly return to normal. In sports medicine we classify them under a traumatic brain injury,” she said.

I was also surprised to learn that ibuprofen is a no-no when it comes to treating any discomfort around a concussion. “Don’t give someone with a concussion ibuprofen for the first two to three days because the brain is already injured and there’s concern about bleeding. Acetaminophen is recommended,” Dr. Schaefer advised.

Hydration is helpful for the brain too. The brain is 80 percent water, so adequate water intake can help it heal. Even being slightly dehydrated can delay recovery and worsen symptoms of headaches, fatigue and dizziness.

Related: The Top 10 Signs of Dehydration

Reaction time assessments are also used for concussions to “assess neuromotor function and response,” Jason Cruickshank, Cleveland Clinic’s Senior Athletic Trainer and Neurocognitive Specialist, explained.

“Concussed patients can be slow and even appear sluggish. We have something called a 'choice reaction time metric' which gauges decision making and impulse, allowing us to assess tasks such as driving, play calling, and other tasks that require quick reactive decisions in the moment, like applying a car brake,” Cruickshank said.

I found it fascinating when he said that the angle of the strike to the head is just as important as the speed of the object and that the acceleration of an object like a volleyball is greatest at the moment of impact.

“The angle of the strike to the head can indicate what part of the brain may be affected and whether or not the neck can be injured due to whiplash,” Cruickshank said.

While our daughter was hit in the front of the head, doctors pointed out that severe blows to the back of the head can pose more danger to the brain—including the possibility of paralysis or death. “The base of the brain connects to the spinal cord and a severe blow in that area could disrupt regulated breathing causing unconsciousness or severe physical injuries. That area is where the brain stem is located which also regulates motor skills like walking and running,” Dr. Schaefer noted.

Related: The #1 Best Food for Brain Health, According to a Neurologist

The Timeline of Olivia's Recovery

As Olivia slowly started to recover, her school’s athletic trainer had her ride a stationary bike while she was carefully observed and tracked her progress each week.

“We want to see how long the patient can tolerate riding the stationary bike without symptoms. We can also track if concussion symptoms are improving when their pulse rate stops rising too fast,” Dr. Schaefer explained.

If her athletic trainer felt she wasn’t 100 percent better, he would delay her return to volleyball by a week—which happened twice.

“Plenty of rest in the first 48 hours after a concussion diagnosis is important and then start with about 15-minute walks each day. It’s believed light exercise helps with the healing process because it decreases inflammation in the brain and body by increasing blood supply,” Dr. Schaefer explained.

It took about 25 days, but eventually, Olivia's trainer and doctors cleared her to return to practice.

However, they stressed the importance of protocols by taking recovery slowly. They said she could only do light drills off to the side of the court with one other player. Eventually, she returned to full practice and tournaments. Months later, she won an award on her high school volleyball team for her leadership on and off the court. I mention that because I’m a typical proud parent, but it also shows she did fully recover.

Sports are so important for kids and teens who learn about teamwork, the benefits of exercise, and building confidence. For this dad, it taught me about the importance of dedicated concussion researchers, doctors and athletic trainers who are teaming up to discover the newest ways to diagnose and treat concussions.

If you’d like to learn more about concussions, treatment and protocols, you can read the Cleveland Clinic’s concussion page.

Next up: The Top Signs of a Severe Head Injury, According to Doctors

Sources

• Dr. Marie Schaefer, MD, a doctor who specializes in pediatric concussions at the Cleveland Sports Medicine Institute.

• Jason Cruickshank, Cleveland Clinic’s Senior Athletic Trainer and Neurocognitive Specialist