Game plan for students who suffer concussions needs to include academics

MOORHEAD - It’s been three weeks since Taylor Hagness was diagnosed with a concussion, and she’s just now getting back into the swing of things when it comes to school work.

The Moorhead High School freshman was smacked in the noggin by a ball while playing indoor soccer the weekend before Thanksgiving.

“It actually didn’t seem that bad,” she said.

In fact, she finished the game.

But when she got back to school Nov. 19, she knew something was wrong.

“I was studying for a test, and I had no idea what it was,” Hagness said.

At the end of the day, she took a computerized test to compare her mental and physical abilities with a baseline test she had taken over the summer.

She flunked. Badly.

Her experience isn’t unusual.

A lot of emphasis is put on recognizing the damage concussions can have on athletes, but concussions can have broader implications for young people than whether they play in the next game.

Academic game plan

Experts say people may focus on getting back to the playing field, but students really need a plan to regain their academic groove.

For three weeks, Hagness has been on a slow mend in terms of being able to handle schoolwork.

“He (the doctor) told me to sleep. That’s my activity for the last two weeks,” she said.

“I have a total of an hour a day for TV,” Hagness said. And she couldn’t text.

“Terrible,” was her verdict for the teen post-concussion purgatory.

“She’s essentially put her life on hold,” said her mother, Nicole Hagness.

But Taylor Hagness’ post-concussion tests results bounced back. And Thursday, she was cleared to return to the soccer practice.

North Dakota and Minnesota require “return to play” protocols for athletics, but the Fargo and Moorhead school districts don’t have formalized “return to academics” protocols.

Administrators and staff said they follow the recommendations of doctors when it comes to reintegrating students into school after concussions.

That’s probably the best way to go, said Dr. Jeff Lystad, a sports medicine specialist for Sanford Orthopedics and Sports Medicine.

“Every concussion is different from kid to kid,” the Fargo doctor said.

Each child Lystad sees returns to school with a form that details how much physical or cognitive exertion they should be exposed to.

“I really shut kids down quite a bit at the beginning of a concussion,” he said.

Many students don’t go to school for a day or two, then part time for a day or two.

Other restrictions might include no more than one test per day, or requirements to cut back on audio stimulation. In that case, they might not go to band, orchestra or choir classes early during the recovery from a concussion.

“They don’t go to phys ed or exert themselves until all symptoms have resolved,” Lystad said.

They also they don’t go to computer classes for the first week, he said.

Breaks, workload and attendance might also see restrictions, which are modified or lifted as the student’s concussion symptoms improve or disappear.

In Taylor’s case, her doctor said she should go to the library instead of gym and band to avoid physical activity and noise.

She also wore sunglasses because the fluorescent lights at school were too bright.

One teacher turned out the lights for her, she said.

Ease back to routine

Lystad said it’s important to ease students affected by concussions back into the classroom.

“First, we need to get them back to being a kid. Next, a student. And lastly, an athlete. So we have this progression of, ‘We’ve got to get you back to functioning well within your family and school,’ and then we worry about getting you back to hockey and football and that type of thing,” Lystad said.

In the United States, 1.7 million people annually suffer a traumatic brain injury, the Centers for Disease Control and Prevention estimates.

Of those, 75 percent are concussions or other forms of mild traumatic brain injury, the CDC said.

North Dakota, Minnesota and at least 41 other states and the District of Columbia have sports concussion safety laws, according to High School Today magazine and news reports.

A concussion is not just a bump on the head, but a traumatic brain injury. The symptoms following a concussion can range from mild to severe, the Rocky Mountain Youth Sports Medicine Institute says.

They often include confusion, disorientation, memory loss and slowed reaction times.

“It’s easy to see a kid walk in with a cast on their leg. You know they’re hurt,” Lystad said. “And a kid walks in after concussion, and you don’t see that. They may be smiling and they may be joking with their friends, but they’re not functioning very well.”

He said it’s a functional problem, not a structural problem. “You can’t take an X-ray or a scan and see a concussion,” he said. “You have to take a look at how they’re functioning. And that takes a little snooping on our part.”

It didn’t take a lot of snooping to realize that Jamieson McVicar had gotten his bell rung.

On Oct. 9, the Fargo Discovery Middle School seventh-grader was playing football for his F-M Athletics team when he took a hand-off and tried to scoot for some yardage.

“A linebacker picked me up and put me on my head,” McVicar said. “I wobbled to the sideline. I knew something was wrong.”

His mother, Kim McVicar, knew her son probably had a concussion.

“I knew as soon as he pulled his helmet off. He had an odd, glassy stare,” she said.

What they didn’t know, until being checked out by a doctor, was just how bad it was.

There were headaches. He slept much of the first week of his recovery. He missed four full days of school and two half days.

“It sucked. I was really bored and sad,” Jamieson McVicar said. “I had never experienced this in my life. I wanted to go back to school! That was weird.”

It was four weeks before Jamieson was back up to speed academically and physically. Over that time, he had four concussion impact tests.

McVicar, like Hagness, was surprised by just how much he was affected mentally and physically.

“I think the scores were surprising,” he said. “I didn’t know how to react to it.”

Lystad said it’s important to shut students down for the first week or two of their recovery.

In general, he said two to four weeks is the standard recovery time from a concussion.

But it can be much longer for some people, particularly if they don’t take it easy early on.

“It can linger for a lifetime with some people,” Lystad said. “We just don’t know who those people are. That’s what we’re trying to avoid.”

In the meantime, McVicar is back into the rough and tumble of sports.

“I’m back into hockey and playing to my normal potential,” he said.

Kim McVicar said she knew just when her son had turned the corner in his recovery.

“I knew he was starting to get better when he started annoying me,” she joked.

Readers can reach Forum reporter Helmut Schmidt at (701) 241-5583

Concussion symptoms

There are many symptoms that can come with concussion.

Physical

• Headache/pressure

• Blurred vision

• Dizziness

• Poor balance

• Ringing in the ears

• Seeing “stars”

• Vacant stare/glassy eyed

• Nausea

• Vomiting

• Numbness/tingling

• Sensitivity to light

• Sensitivity to noise

• Disorientation

• Neck pain

Cognitive

• Feeling in a “fog”

• Feeling “slowed down”

• Difficulty remembering

• Difficulty concentrating/easily distracted

• Slowed speech

• Easily confused

Emotional

• Inappropriate emotions

• Personality changes

• Nervousness/anxiety

• Feeling more “emotional”

• Irritability

• Sadness

• Lack of motivation

Maintenance

(How a person experiences their energy level and/or sleep patterns.)

• Fatigue

• Excess sleep

• Trouble falling asleep

• Drowsiness

• Sleeping less than usual

Source: Rocky Mountain Youth Sports Medicine Institute

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