I am from Longmeadow, MA.  I went to Wake Forest University School of Medicine

 

I wanted to study medicine in order to help people who are sick and to help prevent future injury/illness if possible. 

 

My treatment philosophy is one of individualized Patient centered care. I also strongly believe in a collaborative approach towards the decision making process involving both the patient and parents.

 

The child athlete is focused on the here and now. I have to help them realize we need to take care of the current injury so that in the future it doesn't lead to a recurrent problem and the only way to achieve this is complete rehabilitation of the current injury.

 

Pediatric and Adolescent Sports Medicine

 

Concussions are caused by a direct blow to the head or by a blow to the face, neck, or elsewhere on the body with an impulsive force transmitted to the head. Loss of consciousness occurs in less than 10% 

of concussions.  A concussion is a functional disturbance and not a structural injury. Therefore, a normal CT scan does not rule out a concussion but rather an alternative diagnosis such as a bleed in the brain or a skull fracture. Concussions are no longer graded. The severity of the injury is determined only after all the symptoms have resolved. Athletes should never  return to play on the same day as the injury.

A concussion  is the one thing that children and adolescent take longer to heal from compared to adults. The younger you are the longer it takes to recover.  Only 40% of adolescents will recover in 2 weeks from a concussion.  Concussion symptoms resolve 1-3 weeks before the brain has healed. This is why the NJSIAA now requires the athlete to be symptom free for 1 week before beginning the graduated return to play exercise protocol.  It is extremely important to note again: loss of consciousness occurs in less than 10% of concussions.

During the recovery period, in the first few days after an injury, it is important that both physical and mental rest occur.  Activities that require concentration and attention may exacerbate the symptoms and, as a result, delay recovery.  Too much physical activity can also re-aggravate what may seem to be improving symptoms.  So while you still have symptoms, it is best to rest completely.  This means staying home from school, no homework or studying. You should limit any activity requiring concentration to very short time blocks (10-20 minutes). This includes text messaging, TV, video games, listening to music, reading, activities on the computer, etc. Once they have no symptoms at rest and can tolerate a couple of hours of reading and focusing they may return to school. Until they have recovered completely your physician may recommend temporary accommodations to facilitate return to school. The importance of complete rest is crucial because  there has to be a careful balance between sufficient brain rest, to promote healing, and academic demands. The athlete should not resume exercising until all their symptoms at rest are gone, any cognitive difficulties have resolved, and there physician has cleared them. They then should begin the graduated return to play exercise protocol which follows a stepwise process.

That is a difficult question to answer. Our understanding of  concussions is still in its infancy. At this  point doctors still can't say with one hundred percent certainty that a concussion is ever truly  healed. Hopefully, in the next 10 years we will have a better grasp of the acute consequences in the child and adolescent athlete and the long term consequences of concussions. Right now the key is educating parents, athletes, coaches, and referees about the signs and symptoms of concussions. So that athletes who sustain a concussion are identified and are removed from play before sustaining further injury. Cognitive and physical exertion is then limited thereby reducing the severity of the injury.

 

I enjoy exercising, photography, traveling, hiking with my dog, spending time with my family, and hanging out with friends.