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| Q&A: Dr David Hartman on Head Injuries (824 Posts)
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Thanks Dave
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On 6/28/2006 Justin
wrote in from
South Africa
(196.25.nnn.nnn)
Thanks for the info. I have not experienced any of the above mentioned like imbalance, nausea, double vision, bad headaches or any leaking and the smoking is been phased out. I'll be double checking my helmet for any kind of internal and external damage as well. If it persists for anything longer than another week I'll go check it out with my local doc.
Justin
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Justin Pain
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On 6/28/2006
Dr. Dave
wrote in from
United States
(24.13.nnn.nnn)
Justin,
O.K. Assuming you have not developed balance problems increasing headaches, double vision, nausea, unequal pupils, leaking of fluid from your nose or ears etc. you may have bruised the bone or a cranial nerve. A helmet probably saved your brain from a major impact injury at that speed, so if the helmet got dinged, don't forget to bury it with honors and get a new one.
Now, if there is even a hint of things getting worse, or ANY of the above symptoms check it out personally with the doc ASAP. You've got only one head amd it's the most important part of your quiver.
If the symptom is minor and diminishing, call your favorite family doc anyway and ask about matching you with an appropriate pain killer. And smoking of any kind impedes healing, so ditch the cigs. . .or whatever.
Let us know what happens. . .good luck. Dr. Dave
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Pain in head?
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On 6/22/2006 Justin
wrote in from
South Africa
(196.25.nnn.nnn)
Dave, I raced in march 2006 and had a bail at about 55- 60kmh. I tumbled and hit my head. I was wearing what is still a new MX helmet dot approved. The area I hit was just above but behind my left ear. I got up pretty quickly and did not feel dizzy or get a concussion and my helmet felt like it did it's job. There was a doc on hand that witnessed the fall and rushed to my side but I got up feeling ok and skated away. Being a social smoker, Ive gotten a pain which starts from where I hit my head and moves to my front left temple if I cough or I bend down and pressure is aplied to my head I can feel this pain, which has only started about a week ago. Dont suppose you have any suggestions as to what could be causing this pressure pain. I never experienced anything unusual after the race until now.
Justin
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Christian's Story
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On 6/10/2006
Dr. Dave
wrote in from
United States
(24.13.nnn.nnn)
Christian,
That's an amazing, horrific story with an equally amazing recovery. There's nothing I can add, except to emphasize that Christian's recovery to that degree is very lucky. He could equally well have wound up on the disability roles, or worse, the death stats for skateboard-related head injuries without helmets.
So what rationale can you use to put on the helmet? Pick any one of Christian's possible bad outcomes, and if you include some social consciousness, the idea of the state spending 3.5 million tax dollars to put Humpty together again should be cause for pause. Great post, Christian! Thanks! Dr. Dave
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My Own Helmet Advice
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On 5/22/2006
Christian
wrote in from
United States
(157.201.nnn.nnn)
Helmet safety is unfortunately a topic of controversy and debate. To me it is a simple fact that I will always wear one!!! I used to hate them, until I learned the hard way. Fortunately enough, the entire State of CA has been able to learn from my mistake. Here is what occurred:
It was a Friday afternoon of a minimum day of school on 5 Oct. 2001 and a couple of my buddies and I went out riding and I took a pretty gnarly spill. I Ended up with bi-temporal contusions, and vertical and lateral fractures to my skull. I was immediately thrown into seizures and began bleeding from all of the pores on my face. Upon entering the hospital I suffered from pneumonia, a heart-attack, a tracheotomy that included the paralyzing of my left vocal cord, severe clotting (to the point of legitimate consideration of amputating all four limbs). The list goes on and on and on, to include everything from my left pupil exploding, to the hellish rehabilitation process of relearning how to walk, talk, and function all over again.
I learned from my mistake, so that YOU will not have to from yours. My helmet was in the trunk of my car no more than 40 feet from where I ultimately fell. I have recovered miraculously without any real lasting side effects. I have spoke at a number of elementary schools and am now attending college to pursue my eventual JD & MBA degrees. I was being filmed by my friend, and have taken the footage and created a short helmet-safety clip that is currently distributed by my non-profit (“Wear A Helmet, Inc.”) to Elementary schools all over CA. I spoke in favor of the helmet bill, now a law, to the CA State assembly and Senate and it is now required that all minors under the age of 18 wear a helmet while riding a skateboard, scooter (specifically including Razors), as well as Skates (in-line and otherwise). It was an expansion of the already existent bike helmet safety law.
It just makes sense!!! While I would argue that it was my decision and that I need not be told, ordered, or even commanded by law to wear a helmet; it was never my choice, nor should ever be my choice, to put my family through what they were subjected, as well as ring up the $3.5 million hospital bill.
I did not wear one because I thought that I looked like a loser with a helmet on-but really who was the loser when I fell?
Wear One—it is easily worth it!
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brainzzzzz
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On 4/23/2006 snoball
wrote in from
(70.127.nnn.nnn)
Hey Phil, the doc's right. But be patient with him and don't freak out about any changes that may take place in his personality or thinking. I'm a survivor myself and can say that once his skull heals there won't be any visual clues to others that he's suffered an injury ( like a cast on a leg ) to tell people why this or that is happening with him and he'll likely not whant to wear a t-shirt that says,"I'm brain damaged, be patient." LOL Some of the changes don't surface till later, others are immediately apparant but then go away. The brain's complex that way I guess. I can write but often have difficult verbalizing my thoughts, word search or just quit trying and shut up. The main thing is he's alive and the brain has a pretty good rebound ability but also doesn't forget injuries ( that's what my neuro told me anyway ). They'll likely never want to see him back on a board, but he'll skate again and a helmet will help prevent or minimize any furhter injuries. Already he's lucky too because he has a freind who gives enough of a damn to be supportive and want to be helpful.
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Phil's friend
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On 4/17/2006
Dr. Dave
wrote in from
United States
(68.251.nnn.nnn)
Phil
The best answer to both your questions is the same: Wear a helmet for all boarding and tell everyone else to do the same. If one person with severe brain injuries saves the lives of even two other people, that's pretty important.
The best helmet is the one that you'll wear all the time, that gives you coverage on the front, back and sides, and that's CPSC or equivalent rated. Vented, whatever. Just wear it. Everybody's head is different, so everyone has a different preference, but if it's a rated helmet, it's the best we got.
If your friend is recovering, he might benefit fron a rehabilitation program that emphasizes cognitive and motor rehab, and maybe hook up with a neuropsychiatrist who has experience with antidementia medicines to see if he qualifies. He should have his cognitive function worked up by a hospital or outpatient neuropsychologist to see what's working and what's not. And if you are really his friends, take his boards away unless and until his doctor says it's O.K. When he's able, play video games with him, talk to him, make him think. The axiom 'use it or lose it' applies to your brain as well as other parts.
Good luck to you both.
Dr. Dave
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Cracking of the Skulls
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On 4/12/2006
Phillip Hickey
wrote in from
United States
(71.193.nnn.nnn)
hey dave...
so my good buddy took a horrible dive off his board yesterday, cracked his skull in two places, and has severe brain trauma, and all of us who have been longboarding for bout 10 years now, are lookin in to all getting good helmets, and all that s#@!...umm any good suggestions..?
and also what can we do for my buddy? like what is the BEST thing we can do to help him out?
thanks...
phil
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Sarah Burgess
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On 4/10/2006
Dr. Dave
wrote in from
United States
(68.251.nnn.nnn)
People, if Sarah needs donations, find out what she needs. Help her out if you can.
A couple of comments. First. CONCRETE PILLARS!? Whoever designed that ramp set up needs to get a clue that padding is a good idea. I hope that the park fixes that ramp before the attorneys descend.
Second. Don't remove a helmet of someone who is having a seizure unless you are a paramedic and have training. Removing a helmet involves moving someone's neck, and if their neck is broken, they can be paralyzed or killed by the movement. Keep them on the ground, get the paramedics fast. Unless they last a long time, seizures are scary, but not intrinsically harmful. Don't give them something to bite or fish for their tongue or those other myths. Just keep them from hurting themselves further on the ground.
Third. Get Sarah referred for a neuropsychological evaluation when she is physically recovered. This will help figure out the state of her brain from the accident.
Fourth. Somebody hold on to Sarah's boards for a while.
Fifth. Boarding helmets should protect the side of the head. If the helmet rides too high, it's too easy to smash up the side of your head. The helmet should protect front, back and sides. Don't use a bicycle helmet. It's not enough coverage. Use the chin strap.
Sarah, if you are reading this, we're with you. Stay strong.
Dr. Dave
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No Tow!
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On 4/10/2006
Dr. Dave
wrote in from
United States
(68.251.nnn.nnn)
This is sad because there is no safe way to get towed on a board. You rapidly ramp up to speeds that shortboards can't handle well, and even greater than longboards or kiteboards typically see. The board isn't stable at those speeds, and needless to say, without a helmet, there's really no chance of coming out of a collision. It's like being dropped on your head from a 20 story window. The only thing that helps, I think is to publicize as much as you can the dangers of tow-boarding and skating without a helmet.
I agree, It's not "cool" to lose 3/4's of your life span on a sure-lose bet. If you are going to do it anyway, sign your organ donor card and make sure your will is exactly the way you want it. If you have kids of your own, think of them making their way in the world without you because that's the most likely scenario. I am deeply sorry for your loss.
Dr. Dave
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Frankie's Flatland Head Question
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On 4/10/2006
Dr. Dave
wrote in from
United States
(68.251.nnn.nnn)
Apologies for the delay, people. It's been a hectic month. First, Frankie, think of your head as the top of a hammer and your body as the handle. You are moving on the board on flatland. The board hits a pebble, stops, and you continue the momentum of the board. Junior High Physics so far? O.K. Your head then effectively acts like a hammer into the ground.
Now I've got a real human skull sitting in my office front of me (Doctors get interesting paperweights) and when I upon up the skull (it's pre-sawed) and measure, the thickness of the bone is about 1/8" on the sides above your ears (Temporal Bone) and about a 1/4" at the thickest in the front at back.
With me so far? Your head is a hammer 1/8-1/4 inch thick and it is headed into the asphalt from about 4-6 feet off the ground. Got the picture? It's not a pretty one (see the other posts recently). Bottom line is that even in flatland, your head is not designed to hammer into the ground. Bucket up!
Dr. Dave
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Sarah Burgess
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On 3/31/2006 SFPS
wrote in from
United States
(68.114.nnn.nnn)
I just got the full story on Sarah Burgess (portland advocate who was injured earlier today) Kent Dahlgren just posted this account of what happened earlier today in the forums on our main site...
Kent wrote:
"The miniramp at the DOS has concrete pillars on the sides, on the flatbottom. They have a 45 degree beveled edge on them.
She slammed on a 50-50, slid down the transition, and hit her temple on the edge of the concrete pillar. She had a helmet, but it came in under the edge. I was standing and watching it happen, so was able to respond in moments; I knew from how hard she hit that it was dammed serious. It twisted her head sort of gross and she went limp.
She was in convulsions for 5-6 minutes. I took my shirt off, took her helmet off (as gently as possible). I've been trained for first aid in the service, and another skater was a lifeguard. We cleared the ramp and assigned someone to get an ambulance.
I held the shirt on a large and flowing head wound (3-4 inches) while I checked her for breathing and heartbeat. She was in convulsions, making grinding noises, and shaking all over. Her fists rigid. It scared the f#@! out of me. It's been said that when Sarah falls even Duane Peters has to turn away. This was one of those slams.
As she came out of the convlsions she started fighting and screaming. I had to sit on her right arm while Jason held her left. She's not big, but she's exceptionally strong, and I needed to hold the shirt on her head. She'd already soaked my shirt with blood, my hand was soaked, and it was pooling deep on the ramp. She lost a lot.
Ambulance arrived and within minutes she was congiscent, barely. They loaded her up and we've been at the hospital ever since. I guess it happened at 4:30 this afternoon.
She's had a couple cat scans. So far, no indication of brain bleeding, but her vitals are screwy, blood pressure low, and there's concern about her neck. She gets another one tomorrow am and an appointment with the neurologist. She'll probably stay a couple days at the hospital and may be released this weekend."
OK, so there's the skinny, straight from a witness...
She's gonna need some help folks, and she deserves it-shes raised thousands of dollars for parks here in portland, and her video-screening-as-fundraiser has been duplicated all over the country to great success everywhere. To put it simply, Sarah is a f#@!ing soldier.
Please, take a moment to send positive energy/prayers/a slappy session on your favorite curb/etc her way.
Thanks for reading, and keep a good thought for Sarah.
If you'd like to make a donation to help Sarah with what is no doubt going to be some pretty major medical expenses, we have a paypal account on the main site, located at www.skatersforpublicskateparks.org Please be sure to include a note indicating the $$$ is for Sarah.
any companies, band, etc who could donate merch for an auction, please let us know. Lance from voxx shoes has already stepped up and offered some autographed shoes. every little bit helps. Do what you can, even if it's just doing a grind in her honor. She'd like that.
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Another Sad Example
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On 3/29/2006 Andy (GBJ) Bittner
wrote in from
United States
(69.140.nnn.nnn)
Hey Dr. Dave, I'd like to note, for the record, that a 23 y.o. young man from San Diego, named David Hays, decided, last week, that towing from the bumper of a car on his skateboard, while wearing no helmet, would be a fun and entertaining way to pass some time. Well, the car got going faster than David could handle and when he cast off, he lost control and fell, hitting his head on the pavement. David Hays was my cousin. Brain dead from the accident, they turned off his life support equipment today and let him die. (Unbelievably, this is actually the second cousin I've lost in a skateboard/car towing incident.) The bottom line is that "cool" and unworried about safety issues is not worth dying for. Always... ALWAYS wear a helmet when skateboarding and never tow from cars or other powerfully motorized vehicles.
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Skateboarding Head Injuries
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On 3/24/2006
Frankie
wrote in from
United States
(64.136.nnn.nnn)
My parents require me and my brother to always wear a helmet when skating. We only skate techical, not speed-skating. Do you think it's necessary for us to wear a helmet, since we only skate on flat asphalt most of the time?
Thanks,
Frankie
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Way to Go!
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On 3/16/2006
Dr. Dave
wrote in from
United States
(24.13.nnn.nnn)
Gavin,
I think you've got it EXACTLY right! Get them into gear early so it just seems like part of the whole process. And lock up that board when you're not around! Little kids have no frontal lobe decision-making capacity, and it would be just like a kid his age to grab the board and head off into traffic. . .
Dr. Dave
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helmets for kids
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On 3/16/2006 gavin
wrote in from
United Kingdom
(86.143.nnn.nnn)
'Does your 3 year old want to skateboard?'
yes, very much so and i can't leave a board lying around the house otherwise he grabs it. but i hear exactly what you are saying.
the level of skating i will allow him to do is nothing more than rolling along at a walking pace holding my hands, but even for this i want him to be adequatly protected (i also want him to wear gear right from the start as i believe it then becomes part of the way you do something. my dad allowed me to ride motorbikes from three years old, but i always had to wear the proper kit and for that reason i can't touch a bike unless i've got helmet, boots, gloves, back protector etc - it just don't feel right without it all).
i definitely will not let him loose on his own until he's much older.
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Skate helmet for a 3 year old?
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On 3/15/2006
Dr. Dave
wrote in from
United States
(24.13.nnn.nnn)
Gavin,
Does your 3 year old want to skateboard? I wouldn't recommend it. Three year olds don't have the coordination or judgment for that kind of thing. If you have to helmet him for something else, like being on the back of a bicycle or motorcycle, I would get him a helmet for the appropriate vehicle. There may also be ski helmets for kids that young as well.
Personally, I wouldn't do it. I wouldn't want it on my conscience if anything happened. The ground is hard and it's a long sorry lifetime for little kids who survive a severe head injury.
Dr. Dave
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kids helmets (again)
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On 3/13/2006
gavin
wrote in from
United Kingdom
(81.156.nnn.nnn)
i'm still after a helmet for my 3yr old but am increasingly confused. i'd like to get the fuller coverage and better fit of a skate helmet, but both tsg and capix are rated for 5yrs and over. which leaves a cycle helmet as the only 'certified' option for the age, more polystyrene padding but nowhere near the coverage or fit and the helmet shapes tend to be more pointy which i see some safety sites are saying is not a good thing.
if anyone can give me some advice either via the forum or email it would be great. the helmet companies themselves never answer my queries which i guess may be more a legal thing than slackness.
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Aeon Flux Board
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On 3/1/2006
Dr. Dave
wrote in from
United States
(24.13.nnn.nnn)
Spoke,
I haven't posted it anywhere, but if you send me your email, I'll send you the jpg and you can post it anywhere you want. :)
I'm at drdavidhartman1@comcast.net
Dr. Dave
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Aeon Flux
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On 2/28/2006
SPoKe
wrote in from
United States
(67.53.nnn.nnn)
Doc, Good to hear from ya.
Do you have a pic of the board I could see? Is it on the net any where?
-SPoKe
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Typo
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On 2/28/2006
Dr. Dave
wrote in from
United States
(24.13.nnn.nnn)
Should be "CPSC" standard.
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Bradford's Bucket question
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On 2/28/2006
Dr. Dave
wrote in from
United States
(24.13.nnn.nnn)
Bradford,
You can't make any generalizations about how the helmet looks or feels. If it's certified for the purpose it should work to the level of that certification standard. ASTM sells its criteria for 29.00 dollars on the web, so maybe we can convince Adam to spring for it, eh? Snell's standards are public and I believe that the CSPC standards are also public domain, so you can access those on the web.
And skateboard helmets don't just focus on the top of the head - bike helmets are more like that. A good skateboard helmet will give you side and back of the head coverage as well. Which is good because boarders don't tend to fall on top of their heads.. .
Dr. Dave
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Well SPOKE n
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On 2/28/2006
Dr. Dave
wrote in from
United States
(24.13.nnn.nnn)
Hey SPOKE, You have a good memory! I did get the Superbow and it has a long, perfect picture of Aeon Flux on the bottom. As far as looks, it's the coolest board in my collection. As far as skating, it's not my favorite board because it's got too many plies for me to really push-pump it at my weight range (around 160). So it hangs on a door, Aeon-side up. :)
Dr. Dave
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energy absorbpion and shell & padding design
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On 2/27/2006 Bradford C. Riendeau
wrote in from
United States
(64.19.nnn.nnn)
Does relatively a soft shell helmet which gives create a sharper point of impact compared to a hard shell helmet?
Hockey helmets have a soft spot in the temple where the two parts slide to enlarge the helmet for "fit" purposes. I think that spot is particularly vulnerable.
Also why do helmets focus on the impact on the top of the head? My guess is that except for spearing injuries in football, most impact and most concussions are caused by rotation of the body after an impact to the front, side or back of the head and the impact of the front side or back of the head on the ground ice pavement guardrail bumper windshield etc.
Where can one find the actual impact energy absorbed by given helmets?
The ASTM standards are copyrighted and thus the numbers are not publicly accessible.
I think, therefore, there is a false sense of security. For example, I would like to be able to compare hockey helmets to wool net tuques to get a real world comparison.
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Aeon Flux
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On 2/26/2006 SPoKe
wrote in from
United States
(67.53.nnn.nnn)
Hey Doc, its been a while. I talked to you years ago about Pumpkin decks. I I have that 48" x 10" Pumpkin SuperBow with the Aztec Sun God on the bottom. Did you ever get that Aeon board you were talking about? Hope all is well.
-John P
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