Tag Archives: traumatic brain injuries

Falls, health, and moving forward

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Caregiving for a person with any sort of cognitive degeneration is never for the faint of heart.

What’s breathtaking are the decision making processes one goes through for issues large and small. The hardest have to do with health and contending with making choices on behalf of another. At times it feels as if one is skidding across a slippery floor; stepping carefully but with uncertain footing–an apt analogy for the feelings of inadequacy that surface in the throes of working through the decision tree.

Meanwhile, I woke up at about 5:30 in the morning on Monday to the sound of a loud thud. The last thing I could have imagined was hearing Jed’s voice calling out, “help me, get an ambulance, call an ambulance,” in the saddest, softest tones possible.

I quickly surmised that he had either fallen out of bed or fell as he was stepping on to the floor. I’ll frankly never know, but on his way down, he sustained a small laceration on his ear, which bled profusely, along with a mixture of confusion and fear as he struggled to get up.

Helping him to the bed, my next task was to soothe him, while taking his vitals, dressing his wound, and eventually assisting him to the bathroom. Quite surprisingly, he was able to walk there and back on his own with a determined assurance. He was also able to communicate readily by that time, and with no obvious injuries other than his ear, I made the judgment call to forgo an ER run just then, in favor of letting him rest and get back to sleep for a while. I on the other hand, watched, fretted, listened to his breathing, and worriedly scoured the internet for all things falls and traumatic brain injuries.

About nine in the morning I left a message with his neurologist. I spoke with the nurse from the practice around one or so, and at that point, agreed to go to the ER to ensure there were no internal brain bleeds, et al. I had already been giving him a concussion protocol for a mild traumatic brain injury, (thanks to Izzi), but as he tends to be confused in the morning, following it was a bit tricky. He also noted feeling “fuzzier,” so going to the ER made sense at that point–especially since it was the same hospital chain as his neurology team.

A car service ride later, we were fairly immediately brought to a room in the facility, where he was promptly poked and prodded for a couple of hours including vitals, EKG, CT scans, and a full blood work up looking for signs of head and neck trauma, and potential causes for the fall.

Luckily, his brain did not sustain any injuries, but he did have a couple of anomalies in his bloodwork that I’ll be following up on over the coming days–reminding me how much I forget he is also a man in his 70s and prone to the vicissitudes of aging.

I should add a word about ER visits with a dementia patient. Impatience does not begin to describe what happens when the tests are completed. I also didn’t bring water with me (tip for the future)–so the grumps were exacerbated by a bit of dehydration until I grabbed some from a nurse. My challenge was engaging him in things to do while we waited for test results, so out came the iPhone with varying Spotify lists and YouTube videos. He found his favorite; however, on his own–folding his bed sheets, which gave him something to do for a good 15 minutes or so.

Once home, I’m not certain who was more tired, but we managed a quiet few hours. Izzi had joined us by then which gave Jed a wonderful boost, and afforded me a few minutes to collapse in bed.

I’m still assessing what happened and its meaning moving forward–aside from the knowledge that I need to figure out how to make the bed area safer, and really start to think through a better “to go” plan for any future emergency situations. I also always tend to think more about the effects of his cognitive decline and less so about the other things that might effect his health. And yes, I do have my work cut out for me to fortify those aspects of his care as even with once yearly visits to the internist, things happen.

Right now, I’m just taking some deep breaths and reminding myself that looking forward is always an unknowable set of possibilities that one must be open to. That, and a decent night’s sleep.

 

 

 

 

 

Women’s Boxing champ Frida Wallberg KO sends her to the hospital for emergency brain surgery.

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UPDATE 3 (6/16/2013):  The Swedish press is reporting some very good news. It seems Frida Wallberg is off the respirator, awake and talking. It’s also been reported that the bleed was not an internal brain hemorrhage, but a blood vessel at the outer edge between the meninges and the brain. This is excellent in terms of her recovery and likely she will be kept in the hospital for another 5-6 days so that she can continue to be assessed and have the rest she needs. Meanwhile, the matter is being investigated by Swedish boxing authorities.

Women’s Boxing champ Frida Wallberg KO sends her to the hospital for emergency brain surgery. UPDATE 1  & 2 (below)

Boxer Frida Wallberg being assisted by Lucia Rijker and opponent Diana Prazak shortly after Wallberg's devastating KO loss to Prazak on 6/14/2013. Credit: Maja Suslin/Scanpix

Boxer Frida Wallberg being assisted by Lucia Rijker and opponent Diana Prazak shortly after Wallberg’s devastating KO loss to Prazak on 6/14/2013. Credit: Maja Suslin/Scanpix

Swedish Boxer Frida Wallberg (11-1, 2-KOs) suffered a devastating KO in her title fight against the new WBC super featherweight champion, Australian fighter Diana Prazak (12-2, 8-KOs). It has left the wildly popular Wallberg in an intensive care bed at the Karolinksa Hospital in Sweden on a respirator. She was placed in a medically induced coma after receiving emergency surgery to relieve the pressure on her brain from a cerebral hemorrhage. Surgery took place in the early morning hours after the bout.

Prazak spent the night pummeling Wallberg with bombs and rocked her in the 7th round with a sweeping left according to a report on boxingscene.com. Wallberg buckled under the force of the blow, but continued the round.  In the 8th round, seemingly still under the effects of the 7th round blow, Wallberg was on the receiving end of Prazak’s hard punching. Wallberg was knocked to the canvas by short left hook, but after getting up and receiving an 8-count from the referee, Bela Florian, she continued only to be hit by a short right hook which sent her to the deck again.  Bela Florian called the fight at that point and Prazak was given the KO win.

Wallberg was assisted to the corner by Florian, her nose bleeding and tentative in her movements. Even as she was being examined by the ring doctor, one could observe her visibly slumping and hanging on to the ropes. Still he walked away, and it was the quick thinking of Prasak’s trainer, Lucia Rijker who while celebrating her own fighter’s victory saw that Wallberg was in trouble and ran to her aid. Rijker demanded that the doctor return and that Wallberg be given serious medical aid. Wallberg was subsequently attended to and brought out of the ring on a stretcher.

Wallberg’s boyfriend, Robert Ludwig later told the Swedish press that she suffered a cerebral hemorrhage described as a stroke. In other reports, it has been said that doctors may try to revive Wallberg at some point today to assess her condition.

UPDATE 1: According to press accounts from Sweden, Frida was partially brought out of her coma and has had her medications reduced to assist in the process of bringing her to consciousness. That will reportedly happen at about 4:00 PM, 6.15.2013, Swedish Time. No word was given on the state of her injuries or likely prognosis. The press is continuing to state that she suffered a stroke.

UPDATE 2: Wallberg was reportedly awakened, was able to move her fingers and answers questions, but from what could be gleaned, she has likely been re-sedated somewhat to allow her time to heal. There is some cause for optimism, but no answer yet on whether she will make a full recovery from the stroke–and things are still very serious at this point. She remains in the hospital in intensive care.

Whatever happens, under Swedish boxing rules, Wallberg will no longer be able to box professionally in Sweden.  It is also said that she had an MRI two weeks ago as part of her pre-fight medical which showed no signs of abnormality or vessel weakness.

Wallberg’s last fight was 14 months ago against the tough Brooklyn fighter, Amanda Serrano (17-1, 12-KOs). Wallberg won the fight by decision in her native Sweden. Prazak on the other hand most recently fought Holly Holm (33-2, KOs-9) for a shot at the then vacant IBAF and WBF female light welterweight titles. It was Prazak’s only loss.

Responding to questions about Wallberg in a post-fight interview, Prazak with her coach Rijker was overwhelmed by the quick succession of winning the title after a long hard road of training — and the sense that her only way to defeat Wallberg to take the title was by KO, given that the fight was on Wallberg’s home turf in Sweden — and the devastation of knowing that Prazak was so seriously injured.  As Prazak said on her Facebook page last night, “All fighters want the win by KO … just what we had planned and trained for [came] at a big cost.” She went on to say, “My prayers and thoughts are with Frida and her loved ones. Please send your prayers and thoughts for her too.”

Ishika Lay in Recovery, Photo: Florida Times Union

Ishika Lay in Recovery, Photo: Florida Times Union

The injury sustained by Wallberg and subsequent surgery is reminiscent of the devastation suffered by Ishika Lay in November 2011. During Lay’s bid for the National Golden Gloves in the run-up to the Olympic Trials, she collapsed in the ring, the likely victim of second impact syndrome–a form of brain injury that occurs when brain injuries are not given adequate time to heal.

Whenever this happens in boxing — questions arise as to the role that coaches, managers, referees and ringside physicians play in the health and safety of fighters in the ring. The safety of fighters outside the ring, during training, is just as important, if not more so, and it is up to those who care for their fighters to take the precautions necessary to keep their boxers safe–incorporating the adage “when in doubt sit it out.”

It is helpful that in Sweden fighters are required to have brain scans on a regular basis. The fact that Wallberg was cleared two weeks prior to the fight is also good. What we don’t know is whether she sustained any serious head blows in the interval between her MRI and the day of the fight that could have compromised her in some way. By all reports both fighters had tough training camps in preparation for the bout–Wallberg had also been coming to the fight after a 14 month layoff and whether that had anything to do with the severity of her injury is also unknown.

What we do know is that boxers, hockey players, football players, MMA fighters and other athletes in close contact sports sustain traumatic brain injuries–the question is how can we all help protect these remarkable athletes from further trauma. We know that fighters in particular aim for the KO. It is the “cookies” in boxing–and let’s face it, is what garners the big money fights on the men’s side of game, and while women make a pittance by comparison, the KO remains the holy grail.

Making sports illegal is certainly not the answer, but making sports safer with headgear that can minimize the impact of such injuries, as well as vigilance in the gym, on the playing field and in the ring, would seem to be a step in the right direction. Rethinking the importance of big hits is also something to consider–though that is an unlikely change.

Miracles happen, Ishika Lay on the road to recovery!

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Miracles happen, Ishika Lay on the road to recovery!

Back in October at the 2011 PAL Championships as Ishika Lay lapsed into a coma in critical condition at St. Vincent Mercy Hospital in Toledo, Ohio, her family, friends and the boxing world worried that she might not recover.

Ishika Lay in Recovery, Photo: Florida Times Union

Ishika Lay, a consummate athlete who had been well on her way towards a berth in the upcoming Olympic Trials, has turned the proverbial tide, and while she has lost her shot at representing the United States this year, she is well on the way towards recovery nearly four months later.

It is believed that Ishika Lay suffered from Second-Impact Syndrome. While not as well-known as other head injuries, Second-Impact Syndrome occurs when an athlete already reeling from a blow  actually succumbs to a second blow days or even weeks afterwards. As in Ishika Lay’s case, she had taken a shot while sparring ten days before, and had even complained of headaches, but had otherwise not been encouraged to see a doctor or in anyway treat her symptoms.

In her first PAL bout, the likely winner of the contest, she was never hit hard, but athletes suffering from Second-Impact Syndrome can fall horribly ill even from the lightest of impacts due to the fact that their brains haven’t had a chance to recover from the initial impact. This is the likely scenario that felled Ishika Lay.

As noted in Garry Smits article entitled Women’s Boxer Ishika Lay recovers after coma,  the mantra “when in doubt sit it out,” must become the new normal in boxing.  In Ishika Lay’s case, while it would have meant disappointment at being scratched from her PAL match, she wouldn’t have otherwise undergone her life-threatening ordeal.

Thankfully, Ishika Lay is on the road to recovery with thrice weekly rehabilitation on an outpatient basis at a hospital near  her home in Florida, and lots of additional therapy at home with her mother.

Girlboxing sends lots of love Ishika’s way with the sure knowledge that she is being remembered in a lot of prayers.

Links:

Women’s Boxer Ishika Lay recovers after coma (Florida Times Union.com)

Second Impact Syndrome (Good overview from sportsmd.com )

Second Impact Syndrome (National Institute of Health)

Girlboxing on the Radio!

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>>>Update>>>

Here’s a link to the audio on YouTube! 

Girlboxing on the Radio!

Girlboxing will be a guest on the Sports & Courts radio program this morning running from 10:00 – 11:00 AM ET.   The show will be aired on 1010XL – Jax Sports Radio, part of the ESPN radio network.

Tune in if you can, we’ll be talking about the challenges facing Women’s Boxing in the run up to the debut of the sport at the 2012 Summer Olympic Games in London. We’ll also be discussing boxer Ishika Lay’s recent collapse at the 2011 PAL Championships in Toledo, Ohio.  Ishika remains in critical condition — and we’ll be hearing an update on her condition as well as talking about the challenges of keeping safe in the ring.

The link is here:  1010XL Radio  (Once on the site, click on the Listen Live button on the Right side of the screen.)

Sports & Courts Radio Show is the brain child of John M. Phillips a Jacksonville, Florida based attorney with a keen interest in sports, boxing and advocacy for athletes.  His background includes groundbreaking work in the field of traumatic brain injuries.  Website links are here:  Facebook and Sports & Courts Website