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| Q&A: Dr David Hartman on Head Injuries (824 Posts)
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Helmets for Big Skulls!
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On 6/11/2004
North Carolina Long Border
wrote in from
(63.167.nnn.nnn)
Dr Dave,
Thanks dude. We are doing some research. I am also a cyclist and for those you out there in skate land that also ride bikes for road cycling the best fitting helmets I found for large craniums are made by Giro.
Thanks again for your reply and this forum.
Roll on Brothers and Sisters! Roll on Roll on! (wearing a helmet)
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Fit Your Head
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On 6/11/2004
Dr. Dave
wrote in from
(24.13.nnn.nnn)
Thanks, NCB. Really appreciate these stories. The best advocates have been there and done that and come up pro-helmet. Thanks for your story. Tell as many boarders as possible.
As for helmets, hey, I know from personal experience it's tough to find a helmet for a big head. Helmets that fit everyone else just don't work. But for the same reason, I can only say that there's no one recommendation for you. Everybody's head shape is unique. There are just 3 things to look for: Let's call them the 3 C's (1) Comfort - it's got to be comfortable or you won't wear it. (2) Certification: i.e. CPSC, Snell or ASTM (3) Coverage: Back of head, side and forehead. Those lame pointy vented bike helmets are probably not a good bet for a boarder.
Any Mr. Bigheads lurking on this list who can vouch for a good big vented bucket for North Carolina Longboarder? Let us know.
DrDH
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Helmet Suggestions
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On 6/10/2004
North Carolina Longboarder
wrote in from
(63.167.nnn.nnn)
Dr. Dave: While we are on the subject of helmets, I want to buy a new one but am not sure what's the best going out there. I don't ride street luge or do serious downhill racing but I do ride a few really big hills where the speeds are pretty darn fast. I am 41 years old and have a pretty large cranium. Live Matt, I live in North Carolina and it gets damn hot here in the summer so something with good ventalation would be great. Carving, longboard park riding, and bombing medium grade hills are my main skating focuses.
Got any suggestions? I don't mind spending the bucks for a good helmet.
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Helmets and Matt's Crash
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On 6/10/2004
North Carolina Longboarder
wrote in from
(63.167.nnn.nnn)
Matt: Dr. Dave is right on commending you on your story and I applaude you on your interest in spreading the word. I am both a skater and cyclist and in 1981 a lady in a white Ford LTD decided I would make a good hood ornament while I was riding my bike, helmetless! The result was a major skull fracture, a broken vertabrate in my neck, a broken jaw, broken ribs, fractured hip and one hell of a concussion. She actually drove me into a telephone pole at about 40 mph! My head injury was not as severe as yours but could have been. Unfortunately, I permanently lost all of my hearing in my right ear. I am reminded every minute of my life how important it is to wear a helmet especially when someone on my right says" Hey dude, aren't you listening to me"? Can't you hear? You deaf or something, etc?" Your right when you say people don't think it will happen to them. Guess what? It can and it WILL!
Thank you for your story. Spread the word. Helmets can save your life! I am just glad you didn't get killed or become like a food item in the line at a K & W Caferia-plain, tasteless, vegatable!
Roll on Brothers And Sisters! Roll on Roll on! (wearing a helmet that is!)
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Lucky Matt
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On 6/3/2004
Dr. Dave
wrote in from
(24.13.nnn.nnn)
Hey Matt,
Really appreciate your writing in. You are, in fact, a very lucky guy. The kind of hit you took could easily have caused you to be an ex-human, or nursing home material. I think that your having the guts to tell your story here goes a long way toward helping people see that helmets aren't just some abstract option.
Your story is a lot like Patio Mendino's who fell and took a long time to recover. He's won't ride without a helmet now. Google his website. He has a copy of the article I wrote about him for International Longboarder.
Anyway, keep doing what you're doing. Contact your local city or town newspaper, local Y's and any public youth group organizations. You've got a scary story to tell and I hope you tell as many people as possible. I'm glad you're alive, and I think I speak for my readers that we all wish you good karma for the future. Let us know how you're doing and how your talks go.
Best regards, DrDH
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CRACKED CRANIUM
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On 6/3/2004
MATT
wrote in from
(66.169.nnn.nnn)
I was riding some neighborhood hills close to my buddies house in asheville, nc on my longboard around 2 or 3am and was bomming this hill comming out of an apartment complex onto a main road wich intersected forming a 90 deg angle. Going for the ultimate rush and not prepared for what I had comming, I was flying down this hill at an appoximate 30-40mph says my friend who was riding his short board in front of me and he had to bail due to his speed. Needless to say I was going a little too fast. I don't remember exactly how it happened, but I hear that as I tried to make the left turn I lost it and did a flip using the back of my head to pivit. My buddy who was already at the base close to the spill was shocked he came to find after he reached behind my head that I was bleeding badly called 911 and saved my life. I was unconscious in critical condition, it was not looking good, to say the least. After 5 days in ICU and another week in the local hospital I had to have my right bone flap removed due to my brain swelling. I still wait for the second surgury to get the flap put back in. There is no question in my mind that I got extremely lucky in this accident, and believe more than ever that I have a purpose for walking on this earth today. I continue rehab weekly and have beat many odds on where I am today. I feel that going threw this tramatic event has made me stronger and I would like to help somebody just like myself who thought it couldn't happen to them not go threw what I am being forced to go threw today. I am planning some local speaches to the neighborhood kids about helmet saftey and preach the importance to all my peers who ride something, "Protect your head!" I am hopeing that my words will impact a kid more than his mother or father telling him to wear a helmet. I am living proof that helmets are made for reasons and if you choose to skate you should also choose to wear a helmet. If you know of any organizations that would be interested in my story I would love to spead the word and even if I save one life all my time will have been well spent
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See ya
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On 5/28/2004 isabelle
wrote in from
(68.7.nnn.nnn)
I had a "back and forth" going, am a boarder and WAS interested in your opinion.
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Isabelle's opinions, Part the Second
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On 5/28/2004
Dr. Dave
wrote in from
(24.13.nnn.nnn)
Isabelle,
I partially agree with you about excess salt (sodium). It's associated with hypertension in a substantial minority of individuals. But readers of my "Corner" know that if it's not validated by refereed clinical research and good science, I'm not going to stand behind it. Acidic food as toxic is a health food myth. Your stomach contains stronger acid than anything you could possibly eat. Let's not debate this here and let's keep our back and forth to issues that interest boarders.
DrDH
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ASTM v. CPSC v. Snell
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On 5/28/2004
Dr. Dave
wrote in from
(24.13.nnn.nnn)
Mark,
ASTM is another voluntary standard setting body. It's similar and in some cases identical to CPSC. Snell may be a little more stringent.
See the following link: http://www.smf.org/articles/bcomp.html
DrDH
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one last thing
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On 5/28/2004 mark
wrote in from
(192.215.nnn.nnn)
i e.mailed them, and this was the response:
the ripper 2 helmet we offer in sizes youth, small and medium which
fits sizes: hat size 7 to 7-1/4, or measured circumference in inches of 22
to 22.75, meet the following standards: ASTM F-1492 Skateboarding, ASTM F-1447 Bicycling, ASTM F-2040 Skiing and Snowboarding and USCPSC bicycling. this is on the label in the helmet.
it also comes in a large/adult size. i might try one of these.
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Opinions
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On 5/28/2004 isabelle
wrote in from
(209.66.nnn.nnn)
Facts are not opinions....."Isabelle's opinions are just that" and some of my post certainly is, BUT excess salt/acidic foods harmful effects on the body is NOT opinion, but FACTS!
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Look for the Label
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On 5/28/2004
Dr. Dave
wrote in from
(24.13.nnn.nnn)
Mark,
Let us know. Remember that a mfgr *saying* they meet a standard is *not* the same as submitting their product for actual CPSC or Snell testing. Gotta have the label.
drdh
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helmet again
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On 5/28/2004 mark
wrote in from
(64.166.nnn.nnn)
dave, thanks a lot for your input! just yesterday a friend of mine mentioned 'w helmets' to me. i have no idea if their skate helmet is in any way better than others (and they're rather pricey), but apparently they meet the 'ASTM F 1492 for skateboarding' standard (that's mentioned on their website). i'll try to find out more.
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Advice on Advice
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On 5/27/2004
Dr. Dave
wrote in from
(24.13.nnn.nnn)
Just want to emphasize here that Isabelle's opinions are just that. It's good that she's found a solution that works for her, but others may be helped in different ways. There's no single diet or pill that helps everyone. Use what works for you and collaborate with your doc to find the best strategy.
DrDH
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Mark's Helmet
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On 5/27/2004
Dr. Dave
wrote in from
(24.13.nnn.nnn)
Mark,
It's cool that you're thinking of this. You'll board longer and safer. In this case, it's all in the label and the type of helmet, not necessarily the brand. Look for Snell or CPSC stickers on the inside. Snell is better, but CPSC is fine. If you speedboard, look for a full face helmet made for that purpose or a motorcycle helmet. For slow carving, a regular skateboard helmet with one of those stickers is what you need. It's a million times better to wear *any* Snell or CPSC helmet than it is to go bare-skulled, so wear what's comfortable or you'll find excuses not to wear it. You want a shape that covers the back and sides and forehead, so those racy bike helmets may not do the job. Boarders fall differently from Bikers, so get a helmet with that full surround protection. Let us know which one you wind up with.
One more thing. If you take a major header on the helmet, bury it with honors and get another. Most are made to take one major hit and that's it.
Sk8safe DrDH
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Advice
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On 5/27/2004 isabelle
wrote in from
(209.66.nnn.nnn)
Rereading my previous post, I want to verify/clarify that I mean NO HARM to those who devote themselves to helping others.........I don't want to seem crass, but I've had to listen, research, try and decide what works for myself.
Western medicine has so many problems, our U.S. food supply is fully polluted with CRAP/artifical material, we unwittingly look for unhealthy alternatives to health.
Lastly, tomatoes are a high citrus food, so use them in moderation.
Study organic food sources, be suspicious of "products" that claim to help you feel better, try to minimize ALL drugs taken.
PLAY ON PLAYERS!
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Glucosamine with Chondroitin
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On 5/27/2004 isabelle
wrote in from
(209.66.nnn.nnn)
Nothing will work to heal swollen/sore joints if you consume excess salt and/or citrus/acidic products...
Don't waste money, change your eating habits and you will feel GREAT without pollutting your body with even more unneeded stuffs.
The LEADING cause of athritis (sp?)is salt/acidic foods intake and genetic dispositions.
Go do some research for yourself, rather than take anyone's advice, including doctors...........food 4 thought
Personal history,...I've been extremely abusing my body for athletic play since I could walk. I started skating at 37 years old after having 2 children.
One broken collar bone, shattered shoulder blade, blown-out inner ACL on my knee, and 3 dislocations on my shoulder are some of the worst injuries I've gotten skating/surfing/snowboarding.
I eat only organic foods, drink lots of water, don't smoke cigarettes, do yoga daily and stay extremly fit.
I was still having occasional joint discomfort; the conjoint/msn stuff made a little difference and I liked the help, but asked my chiropractor for advice. He told me to stop or severly moderate acidic foods (citrus, coffee etc) AND not consume salted foods. I went cold-turkey for 2 weeks AND I COULD NOT BELIEVE HOW GOOD I FELT.
So now, my oral food pleasures are less but it's definately worth it. Pain sucks and if I'd had a CLUE as to how easy it was to fix mine, I'd done it yyyeeeaaaaarrrrrrrrs ago!
Americans are WAY too prone for the "pill" fix.....Capitalism feeding your brain with false facts.
Educate yourself!
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helmet
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On 5/27/2004 mark
wrote in from
(66.120.nnn.nnn)
hi, not exactly a health issue (but it might become one...), but do you have any input on what the safest skate helmet -in terms of safety standards- would be? or are all the big names (pro-tec, s-one etc.) pretty much the same?
thanks
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Hugh r's unusual medication side effect
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On 5/23/2004
Dr. Dave
wrote in from
(24.13.nnn.nnn)
That's a new one on me, Hugh r. Enjoy. DrDH
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Aspirin
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On 5/22/2004 Dave
wrote in from
(67.168.nnn.nnn)
Thanks. I started taking the LDA 81mg ASA due
to my age. I don't have a strong family hisory
for MI and don't smoke. My blood pressure is under
control, 25mg Atenolol. I will continue to take
LDA and wear a helmet.
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Glucosamine with Chondroitin
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On 5/22/2004 hugh r
wrote in from
(69.166.nnn.nnn)
I have been taking 1500/1200mg of this daily for about 6 months now and must say that it has been a God send for me.
Previously I would have a hard time getting out of bed in the middle of the night and would experience a considerable amount of joint discomfort whenever the humidity would rise. I live in a dry desert that is considered humid at anything above 15%... so a cloudy or rainy day would kill me! I could tell the weather change from my joints faster than the local weather man!
Now though... he is more accurate than I am, and I couldn't be happier. The frequency of the discomfort, it's duration, and it's severeity have dropped by an easy 80%. My worst days now are what my best days used to be.
Only side affect that I've noticed, and it's not even a bad one (and I'm not positive its the pill... might be age) is that I am finding the more ample figured women much more attractive than I used too... HR
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DrD. to D2
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On 5/22/2004
Dr. Dave
wrote in from
(24.13.nnn.nnn)
Dave, Also, for what it's worth, I'm over 40 and take the stuff too.
DRDH
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Dr. Dave to Dave
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On 5/22/2004
Dr. Dave
wrote in from
(24.13.nnn.nnn)
Dave,
As they used to say on MTV's cartoon "The Head" - "It's complicated." First, you're probably on low dose aspirin (LDA) because you've got a risk for heart problems, atherosclerosis, etc. As such, LDA is probably one of the cheapest and best things ever found to reduce MI risk. There's also some literature suggesting that it decreases polyps and colon cancer, so it's potentially good stuff.
However, as you might guess, docs are not exactly falling all over themselves investigating whether boarders on aspirin bleed better than non-boarders. Most of the data look at the geezer generation - older than 60.
One study that specifically looked at LDA was pretty optimistic: (Journal of Neurosurgery. 2003 Oct;99(4):661-5. "Low-dose aspirin prophylaxis and risk of intracranial hemorrhage in patients older than 60 years of age with mild or moderate head injury: a prospective study." by Spektor S, Agus S, Merkin V, Constantini S.) found "that LDA does not increase surgically relevant parenchymal or meningeal bleeding following moderate and minor head injury in patients older than 60 years of age."
On the other hand, in Neurosurgical Review. 1992;15(1):21-5.
"Aspirin as a risk factor for hemorrhage in patients with head injuries." Reymond MA, Marbet G, Radu EW, Gratzl O. found that patients taking aspirin were at elevated risk for developing chronic subdural hematoma following head injury.
Finally, in a group of patients who were both geezers (75 y.o) and who took a major header, There were 14 deaths (38%) in the anticoagulation group, versus 3 deaths in the control group (8%) (p = 0.006). In the anticoagulation group, 4 of 12 patients (33%) taking warfarin died, whereas 9 of 19 patients (47%) taking aspirin died (p = 0.285). (J Trauma. 2002 Oct;53(4):668-72. Intracranial complications of preinjury anticoagulation in trauma patients with head injury.
Mina AA, Knipfer JF, Park DY, Bair HA, Howells GA, Bendick PJ.) I don't have the full article in front of me, but I suspect these geezers were also on higher doses than LDA.
Even more complicated is the fact that other things unrelated to head injury increase your risk of bleeds, including uncontrolled high blood pressure and smoking.
So, bottom line is that if you have a family or personal history of heart disease, there is nothing out there to suggest that LDA is going to mess you up and a lot of stuff to suggest that LDA does reduce risk of MI.
Needless to say, watch out for the complicating risk factors like hypertension, and don't smoke! ALWAYS wear your helmet, and if you do take a header, go to the ER for ANY unusual symptoms, e.g., bad headache, blurred or double vision, slurred speech, change in mental status. etc.
Good luck and good sk8ing DrDH
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Aspirin risks over 40 yrs.
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On 5/22/2004 Dave
wrote in from
(67.168.nnn.nnn)
I am 43 yrs old and have been taking
81mg ASA per day to reduce risk
of MI or stroke. How much am I
increasing my risk of bleeding
subdural hematoma (sp) etc. I
board 1-3 times a week. Thanks
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The Grey Zone
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On 5/12/2004
Dr. Dave
wrote in from
(24.13.nnn.nnn)
Haim,
It's not YOUR job to diagnose you! If one doc is not sure, go to another university hospital and bring your previous records. Pin them down, do not go undiagnosed or untreated, whatever it is. In the meantime, stay cool (literally) and skate easy if you feel up to it.
drdh
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