Tag Archives: children’s hosptial

Subjective evaluation

When I was young I remember that my cousin, Jim, got a concussion. I don’t remember how it happened, but I remember that everyone was worried. It was the first time I’d heard about concussions and because of it, and until quite recently, thought that concussions were A BIG DEAL. I didn’t realize that there were degrees of concussions. Some were mild, some severe. Some life threatening.

A few years ago one of Andrew’s friends and rugby teammates, Eddie, suffered his second concussion and had to quit playing rugby. I talked to him recently and he still cannot play — although he helps the team out now and then by coaching a game or two. He’s replaced rugby with skiing (and according to an article in the school newspaper, cliff jumping).

A few months ago I heard a broadcast about concussions on National Public Radio. It was around the time a Washington Redskins player (I think it was a Washington Redskin) decided to give up his football career because of concussions. The broadcast discussed new research that had been published about concussions and that they were more dangerous than previously thought.

Nearly 3 weeks ago Andrew suffered a mild concussion playing rugby. Apparently he was playing a position he usually doesn’t play, tackled someone, fell backwards with the person he tackled falling on top of him. Or so that’s what people told him what happened. He didn’t remember any of it. He also was “out of it” for the rest of the game as he watched from the sidelines.

We took him to the ER as soon as his friend drove him home. He was sleepy for a day and stayed home from school, but went to school the next day. By Thursday he seemed fine. I’d taken him to his pediatrician on Monday because I was worried about his sleepiness and the doctor suggested that Andrew be checked out by Children’s Hospital’s SCORE program before he return to sports because Andrew tends to like sports that can result in concussions.

I took him to a 3 hour-long appointment at Children’s yesterday. We were both asked verbal and written questions about the incident, questions about before and after the incident and questions about how Andrew feels now. I answered that everything seems to be back to normal. Andrew did too, except he mentioned that he felt a little tired. Not normally, but that he felt tired that morning. He didn’t mention that he’d spent the previous day out with friends, got to bed late and got up earlier than usual for the appointment.

At the end of the appointment we were brought into the doctor’s office (technically a post-doc student) and told that Andrew was almost completely recovered but since he was reporting fatigue (tired that day?) that they still didn’t want him to participate in sports until he was 100% better and that he needed a professional sports rehab facility to ease him back into sports and then have another session at Children’s in a week.

While I don’t dispute the new research about concussions and I do believe that they are more dangerous than previously thought, I do think that much of what we did yesterday was completely subjective. His CT Scan, right after the concussion was fine. He’s been fine for two weeks — not acting tired at all. The tests he took yesterday were all fine. The only abnormality is that he reported being tired yesterday.

This leads me to wonder if this is standard procedure. A kid who had a concussion comes in for an appointment and no matter what the answers, they set up another appointment and refer them to a sports rehab facility. If so, then I think patients should be told this. We might have tried to get an earlier appointment with the SCORE program if that was the case.

I guess I should be glad that someone is concerned about my son and his brain. I only wish that the evaluations were less subjective. There are so many variables. While the bottom line is the health of the child, I know that my child is itching to get back to sports.