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Concussion (transcript)
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Child: THERE ONCE WAS A TIME WHEN WE WERE TRULY FREE -- FREE OF WORRY, FREE OF FEAR, FAR FROM DOUBT. THAT IS STRENGTH.THAT IS POWER. THAT IS FEARLESS. "SECOND OPINION" IS BROUGHT TO YOU BY BlueCross/BlueShield, ACCEPTED IN ALL 50 STATES. LIVE FEARLESS.

 

ANNOUNCER: "SECOND OPINION" IS PRODUCED

IN ASSOCIATION WITH THE UNIVERSITY OF ROCHESTER MEDICAL CENTER, ROCHESTER, NEW YORK.

 

PETER SALGO:

 

THIS IS "SECOND OPINION,"AND I'M YOUR HOST, DR. PETER SALGO. THIS WEEK, "MYTH OR MEDICINE," DOES A NORMAL BRAIN SCAN RULE OUT A CONCUSSION?

 

DR. JEFFERY BAZARIAN:

 

EVERY CONCUSSION HAS THE POTENTIAL FOR THIS LIFE-THREATENING BLEEDING IN THE BRAIN.

 

PETER SALGO:

 

AND SPECIAL GUEST MONICA COOK, WHOSE TIME ON THE SOCCER FIELD HAS BROUGHT HER HERE FOR A SECOND OPINION.

 

MONICA COOK:

 

LAST SEASON I GOT HIT TWICE, TWO CONSECUTIVE GAMES, SO TWO DAYS IN A ROW.

 

PETER SALGO:

 

WELL, THANKS SO MUCH FOR BEING HERE, MONICA. WE'VE GOT A LOT OF DETAILS FOR

YOU TO FILL IN FOR US, AND I WANT TO GET TO THEM, AND I WANT TO INTRODUCE YOU TO YOUR "SECOND OPINION" PANEL. THESE ARE PEOPLE WHO ARE HERE TO HELP YOU, AND YOU'RE GOING TO BE ABLE TO GET YOUR SECOND OPINION FROM THEM BY THE TIME THIS BROADCAST IS OVER. WE HAVE PRIMARY CARE DOCTOR FROM THE UNIVERSITY OF ROCHESTER, DR. LISA HARRIS, AND WE HAVE DR. JULIAN BAILES FROM THE NORTH SHORE UNIVERSITY HEALTH SYSTEM -- DR. BAILES, WELCOME. NOW, MONICA, WE TALKED EARLIER,

AND I KNOW YOU'VE GOT A LOT OF DETAILS OF YOUR STORY, SO WHY DON'T YOU BRING US UP TO SPEED AS TO BASICALLY WHY YOU'RE HERE? WHEN DID YOU START HAVING PROBLEMS? LET'S EVEN GO BACK FURTHER -- WHEN DID YOU START PLAYING SOCCER?

 

MONICA COOK:

 

I STARTED PLAYING SOCCER WHEN I WAS TEN YEARS OLD, AND I PLAYED ALL THROUGH MIDDLE SCHOOL, ALL THROUGH HIGH SCHOOL, AND I GOT MY FIRST CONCUSSION MY FRESHMAN YEAR OF COLLEGE.

 

PETER SALGO:

 

ALL RIGHT, WELL, EVEN BEFORE YOU KNEW THAT YOU HAD A CONCUSSION, I WANT A LITTLE MORE DETAIL ON THIS, BECAUSE THAT'S TOO EASY, "I GOT A CONCUSSION." YOU WERE PLAYING SOCCER, AND, BECAUSE, I MEAN, SOCCER'S NOT A CONTACT SPORT, RIGHT?

 

MONICA COOK:

 

WELL...

 

PETER SALGO:

 

OR MAYBE IT IS, THE WAY YOU GUYS PLAY IT.

 

MONICA COOK:

 

YEAH, IT DEFINITELY IS.

 

PETER SALGO:

 

BUT WHAT HAPPENED EXACTLY?

 

MONICA COOK:

 

I HEADED A BALL OFF A PUNT, AND I HEADED IT IMPROPERLY, SO I KIND OF CAUGHT IT ON THE BACK OF MY HEAD --

 

PETER SALGO:

 

YOU'LL FORGIVE ME, OFF A PUNT?

 

MONICA COOK:

 

A PUNT, SO A GOALIE PUNTS --

 

PETER SALGO:

 

SO THE GOALIE KICKED THE BALL AND YOU PUT YOUR HEAD IN THE WAY.

 

MONICA COOK:

 

[ LAUGHS ] YEAH, IT WENT REALLY HIGH IN THE AIR AND CAME BACK DOWN AND I KIND OF CAUGHT IT OFF THE TOP OR THE BACK OF MY HEAD, WHICH IS NOT WHERE YOU'RE SUPPOSED TO HEAD THE BALL, BUT I FELT MY HEAD KIND OF GO BACK A LITTLE BIT. AND I DIDN'T FALL OVEROR GET KNOCKED OUT. I DIDN'T EVEN COME OUT OF THE GAME OR ANYTHING. IT FELT A LITTLE FUNNY WHEN I TOOK THE HIT, BUT I FINISHED THE GAME, AND THEN THAT NIGHT I HAD A LITTLE BIT OF A HEADACHE, BUT NOT TOO BAD. AND WHEN I WOKE UP THE NEXT MORNING, I FELT REALLY, REALLY SICK.

 

PETER SALGO:

 

WHEN YOU SAY REALLY, REALLY SICK, WHAT DO YOU MEAN?

 

MONICA COOK:

 

I HAD A HEADACHE, MY STOMACH WAS JUST KIND OF UNEASY, I WAS KIND OF NAUSEOUS -- I WASN'T SICK TO MY STOMACH, BUT I JUST DIDN'T FEEL GOOD. I WAS REALLY UPSET ABOUT, I'M NOT EVEN SURE WHAT, AND I JUST THOUGHT MAYBE I HAD A LITTLE BIT, LIKE A TOUCH OF THE FLU OR STOMACH BUG OR SOMETHING LIKE THAT.

 

PETER SALGO:

 

NOW, SHE MENTIONED THE WORD CONCUSSION. DOES THAT SOUND LIKE SOMETHING THAT, IF YOU WERE HER PRIMARY CARE DOC, YOU WOULD HAVE SAID RIGHT OFF THE BAT?

 

DR. LISA HARRIS:

ABSOLUTELY -- I MEAN, SHE HAS SOME VERY CLASSIC SIGNS AND SYMPTOMS OF A HEAD INJURY OR WHAT WE COMMONLY CALL CONCUSSION. SO SHE HAD A TRAUMA TO THE HEAD OR A BACK-AND-FORTH MOTION TO THE HEAD OR A STRIKING TO THE HEAD AND FOLLOWED WITH HEADACHE, WITH CONFUSION, WITH NAUSEA, WITH MOOD SWINGS OR IRRITABILITY -- ALL OF THOSE ARE FEATURES OF A HEAD INJURY OR SOME DAMAGE TO THE BRAIN.

 

PETER SALGO:

 

SO AFTER THAT, YOU'RE AT HOME, YOU'RE NOT FEELING WELL -- MAYBE SOME NAUSEA, HEADACHE, RIGHT? NOT FEELING YOURSELF OR A LITTLE OUT OF IT? DID YOU GO BACK AND PLAY AGAIN, OR DID YOU SIT OUT? WHAT DID YOU DO?

 

MONICA COOK:

 

UM, I SKIPPED PRACTICE THE NEXT DAY BECAUSE I THOUGHT I WAS SICK, AND THEN WHEN IT STILL DIDN'T IMPROVE, I WENT AND SAW THE TRAINER, AND I TOOK SOME  TESTS, AND HE KIND OF DETERMINED THAT I HAD A CONCUSSION AND I SHOULD SIT, SO I SAT OUT FOR A WHILE AFTER THAT.

 

PETER SALGO:

 

NOW, WHAT ARE THESE TESTS? WHAT DOES ANYBODY DO TO TEST FOR A CONCUSSION? I'VE SEEN FOOTBALL MOVIES WHERE THEY SAY, "HOW MANY FINGERS AM I SHOWING," AND IF YOU SAY TWO, THEY PUT YOU BACK IN THE GAME.

 

DR. JULIAN BAILES:

 

HOPEFULLY, WE'RE BEYOND THAT NOW. THE TEST BASICALLY IS TO INTERVIEW THE PERSON OR ATHLETE AND THEN TO DO A NEUROLOGICAL EXAMINATION, BUT TYPICALLY THOSE ARE NORMAL, AND THAT'S PART OF THE PROBLEM WITH CONCUSSION IS THAT THE PATIENT IS WALKING AND TALKING, AND THEY HAVE A "NORMAL" EXAM. SO YOU HAVE TO GO BEYOND THAT. THE NUMBER-ONE THING WE GO BY IS THE SYMPTOM CHECKLIST. WHAT SYMPTOMS ARE YOU HAVING? SOUNDS LIKE MONICA HAD SEVERAL THAT WOULD BE CONCERNING. AND THEN SOMETIMES WE GO TO A NEUROPSYCHOLOGICAL TEST --

 

PETER SALGO:

 

WHAT IS THAT?

 

JULIAN BAILES:

 

WELL, THAT'S NOW DONE ORDINARILY COMPUTERIZED, AND THAT'S REALLY LOOKING AT THINGS LIKE VERBAL MEMORY AND VISUAL PROCESSING, THINGS LIKE THAT, THAT REALLY DRILL DOWN HOW THE BRAIN IS WORKING COGNITIVELY.

 

PETER SALGO:

 

SO IT'S FAR MORE SUBTLE THAN THE EARLIER TESTS WE USED TO DO.

 

JULIAN BAILES:

 

ABSOLUTELY.

 

PETER SALGO:

 

WELL, YOU KEPT TRYING TO PLAY, MONICA? DID YOU GET BACK IN THE GAME FINALLY?

 

MONICA

YEAH, I SAW A DOCTOR IN THE TRAINING ROOM, AND I WAS HAVING HEADACHES LIKE EVERY NIGHT, BUT I WAS MUCH BETTER THAN THE FIRST DAY I CAME BACK, AND SO HE ASKED ME IF I WANTED TO PLAY, AND I SAID OF COURSE I WANTED TO PLAY. SO I PUT ON SORT OF A PADDED HEAD GEAR --

 

PETER SALGO:

I WANT TO STOP YOU -- WHAT YEAR OF COLLEGE WERE YOU IN RIGHT THERE?

 

MONICA COOK:

 

MY FRESHMAN.

 

PETER SALGO:

 

YOU'RE A FRESHMAN IN COLLEGE. THAT PUTS YOU WHAT 17, 18 YEARS OLD?

 

MONICA COOK:

18.

 

PETER SALGO:

 

AND THE DOC SAYS, "DO YOU WANT TO PLAY?" DOES HE, DO YOU THINK ANY DOC IS EVER GOING TO GET, "NO, DOC, PLEASE SIT ME DOWN?"

 

DR. LISA HARRIS

 

NOT FROM AN ATHLETE.

 

PETER SALGO:

 

NO!

 

DR. LISA HARRIS:

 

ATHLETES, THEY'RE GOING TO LIE AND DO WHATEVER THEY NEED TO DO TO GET BACK IN THE GAME.

 

PETER SALGO:

 

I WANT TO KEEP GOING, BUT I JUST WANT TO ASK A QUESTION -- YOU CAN BE AS CRITICAL AS YOU LIKE. THE BEHAVIOR OF THAT DOC TO ASK THAT QUESTION, WAS IT APPROPRIATE OR NOT?

 

DR. JULIAN BAILES:

 

WELL, IT'S NOT INAPPROPRIATE IF THAT WAS ONE OF MANY QUESTIONS. YOU REALLY HAVE TO GET AT HOW THE PATIENT IS DOING, WHAT THE SYMPTOMS ARE, AND TRY TO SEE IF YOU CAN DECIDE WHAT'S GOING ON. THIS IS AN INJURY THAT HAS NO, ORDINARILY, NO OUTWARD MANIFESTATIONS.

 

DR. LISA HARRIS:

 

RIGHT, AND I THINK THE ISSUE IS NOT SO MUCH THE QUESTION BUT WHETHER OR NOT HE BASED HIS DECISION ON HER ANSWER.

 

PETER SALGO:

 

GOOD POINT. IN ANY EVENT, YOU WENT BACK AND PLAYED?

 

MONICA COOK:

 

MM-HMM.

 

PETER SALGO:

 

AND WHAT HAPPENED?

 

MONICA COOK:

 

I TRIED TO PLAY IN A FEW PRACTICES, I GOT IN ONE MORE GAME, AND AGAIN I GOT THROUGH THE ENTIRE GAME, AS I NORMALLY WOULD, BUT IT WAS AFTERWARDS THAT I REALLY DIDN'T FEEL WELL. SO AFTER THAT, I SAT AGAIN.

 

PETER SALGO:

 

DID THEY SEND YOU TO A DOCTOR AT THAT POINT, OR WHAT HAPPENED?

MONICA COOK:

 

YEAH, SO I SAT, AND I WAITED A WHILE TO SEE IF THE SYMPTOMS WOULD CLEAR UP, AND EVENTUALLY I WENT TO SEE A NEUROLOGIST.

 

PETER SALGO:

 

AND WHAT DID THE NEUROLOGIST SAY?

 

MONICA COOK:

 

HE DIAGNOSED ME WITH POST-CONCUSSION SYNDROME.

 

PETER SALGO:

 

OKAY, THAT'S A BIG PHRASE. WHAT IS POST-CONCUSSION SYNDROME?

 

DR. JULIAN BAILES:

 

IT'S HAVING SYMPTOMS OF A CONCUSSION AFTER A CONCUSSION.

 

PETER SALGO:

 

I WAS AFRAID YOU WERE GOING TO SAY THAT!

 

DR. LISA HARRIS:

 

SO IT'S ASSUMING THAT THE ACUTE INJURY HAS "RESOLVED" AND PATIENTS HAVE ONGOING SYMPTOMS, AND THAT'S WHAT --

 

PETER SALGO:

 

I WANT TO BACKTRACK A LITTLE BIT. WHEN MONICA GOT HIT THE FIRST TIME AND SHE FELT FUNNY AND HER HEAD WAS EXTENDED -- RIGHT, IT WENT BACK, SHOULD SHE HAVE BEEN PULLED FROM THE GAME RIGHT THEN?

 

 

DR. LISA HARRIS:

 

ABSOLUTELY.

 

PETER SALGO:

 

BOTH OF YOU AGREE ON THAT OR NO?

 

DR. JULIAN BAILES:

 

YES.

 

DR. LISA HARRIS:

 

YES.

 

PETER SALGO:

 

YOU DO. AND HOW DO YOU KNOW THAT? SHE'S OUT THERE PLAYING. SHE HEADS THE BALL --

 

DR. LISA HARRIS:

 

SO SHE HAD SYMPTOMS INITIALLY, AND THAT'S ONE OF THE THINGS YOU HAVE TO LOOK FOR, AND THAT'S ONE OF THE THINGS THAT WE LOOK FOR NOW. SO IF SHE WAS LOOKING DAZED, ACTING A LITTLE CONFUSED, COMPLAINING OF HEADACHE OR NAUSEA OR ANY OTHER SYMPTOM, YOU GET PULLED FROM THE GAME.

 

PETER SALGO:

 

ALL RIGHT, SO WHAT ARE YOU GOING TO DO? CAN YOU TREAT IT? I MEAN, GIVE HER MEDICINE ON THE SIDELINES, ANYTHING?

 

DR. JULIAN BAILES:

 

THE BIG THING IS, IF YOU HAVE A CONCERN, AS A BYSTANDER, OBSERVER, OR AN ATHLETIC TRAINER, YOU NEED TO PULL THEM OUT AND EVALUATE THEM, AND THEN YOU MAKE A DIAGNOSIS OR A SUSPECTED DIAGNOSIS. AND IF THE ANSWER IS YES, THEY DON'T GO BACK TO PLAY IN THAT DAY, THAT PRACTICE, OR THAT GAME. THEN YOU GET INTO TREATMENT. THE PRIMARY TREATMENT IS REST. THERE IS NO MEDICATION AT THAT STAGE, AND USUALLY MOST OF THEM RESOLVE.

 

PETER SALGO:

 

BUT, YOU KNOW, I JUST REALIZED SOMETHING -- YOU MENTIONED THE WORD CONCUSSION, WE'VE TALKED ABOUT THE WORD CONCUSSION, WE'VE EVEN GONE BEYOND IT TO POST-CONCUSSION SYNDROME. NOBODY EVER DEFINED CONCUSSION. WHAT THE HECK IS IT?

 

DR. JULIAN BAILES :

 

IT COULD BE DEFINED ANY NUMBER OF WAYS, BUT PRIMARILY IT'S BRAIN NOT WORKING RIGHT AFTER A MECHANICAL HIT OR TEMPORARY NEUROLOGICAL DYSFUNCTION IS ANOTHER WAY DOCTORS TALK ABOUT IT, BUT IT'S A BRAIN DISTURBANCE THAT IS ORDINARILY TEMPORARY, AND THEN IT WILL RESOLVE, PROBABLY 85% TO 90% OF CASES.

 

PETER SALGO:

 

BUT I NOTICE WHAT YOU SAID DID NOT INVOLVE PHYSIOLOGY, DID NOT INVOLVE SPECIFIC ANATOMY, DID NOT INVOLVE ANY TESTS. IT IS, "THE BRAIN IS NOT WORKING RIGHT AFTER YOU HIT IT." IS THAT GOOD ENOUGH?

 

DR. LISA HARRIS:

 

WELL, YES AND NO -- I THINK ONE OF THE THINGS WE'VE COME TO REALIZE ABOUT CONCUSSION -- I THINK IN THE PAST WE'VE THOUGHT THAT IT'S A DIRECT BLOW TO THE BRAIN, ALMOST LIKE A BRUISE OR A PUNCH TO AN ARM OR EXTREMITY. AND WHAT WE REALIZE NOW IS THAT IT'S MUCH MORE COMPLICATED THAN THAT --

 

PETER SALGO:

 

I WAS AFRAID YOU WERE GOING TO SAY THAT.

 

DR. LISA HARRIS:

 

OF COURSE. IT HAS TO DO WITH THE HORMONES AND THE CHEMICALS THAT THE BRAIN PRODUCES AND HOW IT FUNCTIONS OVERALL, AND THAT'S WHY WE GET INTO COGNITIVE EVALUATIONS, AND THAT'S WHY SOMETIMES IT'S DIFFICULT TO PINPOINT, BECAUSE YOU CAN'T LOOK AT SOMEBODY AND SAY, "OH, YOUR BRAIN IS NOT WORKING WELL."

 

PETER SALGO:

 

WELL, WHAT HAPPENED TO YOU? YOU WERE GETTING HEADACHES. DID ANYBODY SAY, "DON'T GO TO SLEEP BECAUSE WE'RE AFRAID YOU DON'T WAKE UP? WE WERE PAST THAT PART, RIGHT? BUT THEY PUT YOU ON DRUGS FOR YOUR HEADACHE?

 

MONICA COOK:

 

YES, SO AFTER I SAW THE FIRST NEUROLOGIST, HE GAVE ME KIND OF A DAILY HEADACHE PAINKILLER PREVENTATIVE TYPE OF MEDICINE, SO I TOOK THAT EVERY DAY. I MEAN, I WAS IN MY FIRST QUARTER OF COLLEGE, SO I WAS COMING UP ON FINALS AND STUFF, SO I STARTED TAKING THAT AND BASICALLY JUST RESTED, SO STOPPED AN FORM OF PHYSICAL ACTIVITY.

 

PETER SALGO:

 

AND DID YOU SIT OUT THE REST OF THE SEASON?

 

MONICA COOK:

 

MM-HMM.

 

PETER SALGO:

 

WHEN YOU CAME BACK, I KNOW WE HAVE HAD A DISCUSSION ABOUT THIS -- YOU TRIED WEARING SOME HEAD PROTECTION, RIGHT? DID THAT HELP?

 

MONICA COOK:

 

Cook: UM, I DON'T KNOW IF IT HELPED -- I MEAN, IT MADE ME A LITTLE BIT MORE AWARE OF MY HEAD AND WHAT I WAS DOING WITH IT AS FAR AS GOING IN FOR HEAD BALLS AND GOING IN FOR TACKLES AND STUFF.

 

PETER SALGO:

 

BUT YOU'RE NOT SURE -- DOES WEARING HEAD PROTECTION PROTECT YOU AGAINST CONCUSSIONS?

 

DR. LISA HARRIS:

 

NO, I DON'T -- NO.

 

PETER SALGO:

 

YOU'VE WORKED WITH THE NFL TOO, RIGHT?

 

DR. LISA HARRIS:

 

NOT IN SOCCER, LET ME PUT IT --

 

DR. JULIAN BAILES:

 

WELL, FIRST OF ALL, LISA'S RIGHT, IN SOCCER THERE'S NO HEAD GEAR FOR THE MOST PART. THERE IS NO CONCUSSION-PROOF HELMET IN FOOTBALL. WE KNOW THAT. THERE IS A PHENOMENON WHERE THE BRAIN MOVES AROUND INSIDE THE SKULL -- WE CALL THAT "SLOSH," AND THAT CAN --

 

PETER SALGO:

 

THAT'S A TECHNICAL TERM, SLOSH?

 

DR. JULIAN BAILES:

 

WELL, IT'S A TERM THAT I THINK MOST PEOPLE GET. AND THE BRAIN IS FREELY ABLE TO MOVE, SO THAT'S GOING TO HAPPEN NO MATTER WHAT YOU'RE WEARING. NOW, HELMETS DO A GREAT JOB OF PREVENTING MAJOR BRAIN INJURY AND SKULL FRACTURES, THINGS LIKE THAT, AND THEY PREVENT A LOT OF CONCUSSIONS, BUT THEY HAVEN'T BEEN TOTALLY ABLE TO ELIMINATE THE ISSUE OF CONCUSSION -- THAT'S ONE REASON WE STILL TALK ABOUT IT IN FOOTBALL.

 

PETER SALGO:

 

WELL, DESPITE THAT, DESPITE THE FACT THAT YOU SAT OUT FOR A WHILE, YOU PLAYED TWO MORE YEARS, AND YOU GOT TWO MORE HITS, AT LEAST, RIGHT, TO THE HEAD?

 

MONICA COOK:

 

YEAH, I PLAYED TWO YEARS PROBABLY WITHOUT ANY SIGNIFICANT EVENTS, AND THEN DURING MY LAST SEASON, I GOT HIT TWICE, TWO CONSECUTIVE GAMES. SO TWO DAYS IN A ROW, PRETTY SIGNIFICANT --

 

PETER SALGO:

 

WHAT DID THAT DO TO YOUR HEADACHES?

 

MONICA COOK:

 

THEY JUST INCREASED THE FREQUENCY AND THE SEVERITY. SO I HAD HEADACHES EVERY ONCE IN A WHILE, EVERY MONTH OR SO PRETTY BAD THROUGHOUT -- I JUST

STARTED -- BASICALLY DEVELOPED FREQUENT HEADACHES THROUGHOUT MY COLLEGE CAREER.

 

PETER SALGO:

 

SO SHE'S GETTING MORE HEADACHES, SHE'S BEEN HIT A COUPLE MORE TIMES. IS THAT TYPICAL? I KNOW THE WORD YOU MENTIONED TO ME WHEN WE WERE TALKING IS YOU THOUGHT YOU MIGHT HAVE MIGRAINES.

 

MONICA COOK:

 

YEAH.

 

PETER SALGO:

 

IS THIS MIGRAINE? IS IT CONCUSSION? WHAT'S HAPPENING HERE?

 

DR. JULIAN BAILES:

 

WELL, IT IS TYPICAL THAT IF YOU CONTINUE TO GET HIT, ESPECIALLY IF YOU HAVE A SECOND HIT AS SHE DESCRIBED TWO YEARS LATER, AFTER THE FIRST HIT, THAT TYPICALLY CAN ACCELERATE THINGS AND CREATE A CHRONIC STATE WHERE THE BRAIN HASN'T HEALED AND THE SYMPTOMS CONTINUE. HEADACHE IS TYPICAL.

 

PETER SALGO:

 

IS THIS DANGEROUS? SHOULD SHE HAVE CONTINUED PLAYING? OR SHOULD SHE HAVE HUNG THEM UP? WHAT DO YOU THINK?

 

DR. LISA HARRIS:

 

I THINK SHE PROBABLY SHOULD HAVE BEEN PULLED.

 

PETER SALGO:

 

WHAT DO YOU THINK?

 

DR. JULIAN BAILES:

 

WELL, AGAIN, HARD TO GIVE A SHORT ANSWER. THERE ARE WAYS TO MANAGE AROUND THAT. IT SOUNDS LIKE SHE SHOULDN'T HAVE PLAYED ANYMORE AFTER THE SECOND HIT, I THINK, WHEN SHE WAS A SENIOR, SHE SAID. THERE ARE WAYS TO MANAGE THIS, BUT IN GENERAL, NO, IF THE PLAYER IS SYMPTOMATIC, THEY SHOULDN'T CONTINUE TO PLAY.

 

PETER SALGO:

 

ENOUGH, ENOUGH, AS WHAT MY MOTHER WOULD SAY, ENOUGH! YOU DIDN'T SAY, "ENOUGH." YOU PLAYED INDOORS. AND YOU GOT POPPED AGAIN, DIDN'T YOU?

 

MONICA COOK:

 

YEAH.

 

PETER SALGO:

 

THAT'S JUST GREAT. TELL ME ABOUT THAT.

 

MONICA COOK:

 

I KIND OF GOT -- I FELL INTO THE BOARD, SO I DIDN'T ACTUALLY HIT MY HEAD, BUT I GOT MORE OF LIKE A WHIPLASH TO MY NECK.

 

PETER SALGO:

 

OKAY AND YOU WENT TO THE EMERGENCY ROOM?

 

MONICA COOK:

 

MM-HMM.

 

PETER SALGO:

 

WHAT DID THEY DO THERE? DID THEY DO ANY DIAGNOSTIC STUDIES?

 

MONICA COOK:

 

THEY DID A CAT SCAN, YEAH.

 

PETER SALGO

 

SO THEY GOT A CAT SCAN OF YOUR HEAD, AND IT SHOWED...?

 

MONICA COOKE:

 

NOTHING.

 

PETER SALGO:

 

ALL RIGHT, SHE'S GOT A NEGATIVE CAT SCAN, SHE'S NORMAL. SHE CAN PLAY SOCCER?

 

DR. LISA HARRIS:

 

UH, ABSOLUTELY NOT --

 

PETER SALGO:

 

BUT I THOUGHT IT'S A BRAIN INJURY -- WHY DIDN'T I SEE THIS ON THE CAT SCAN?

 

DR. LISA HARRIS:

 

YOU'RE NOT GOING TO SEE IT ON A CAT SCAN.

 

PETER SALGO:

 

SO HOW CAN THERE BE INJURY IF I DON'T SEE IT ON THE X-RAY?

 

DR. JULIAN BAILES:

 

WELL, IT'S NOT SOMETHING THAT SHOWS ON CAT SCANS. YOU DON'T HAVE BLEEDING. YOU DON'T HAVE SWELLING OF THE BRAIN. SO BY DEFINITION, CONCUSSION IS SUPPOSED TO HAVE A NEGATIVE CAT SCAN OR A NORMAL CAT SCAN. SO THAT'S AGAIN WHY YOU HAVE TO GO TO OTHER FORMS OF TESTING.

 

PETER SALGO:

 

SO THAT'S REALLY IMPORTANT, RIGHT? BECAUSE A PARENT WILL TAKE A KID TO THE EMERGENCY ROOM, HEAR THAT THE CAT SCAN IS NEGATIVE, NORMAL, AND SAY, "GREAT, MY KID CAN GO BACK AND PLAY."

 

DR. LISA HARRIS:

 

AND THAT'S WHY IT'S SO IMPORTANT FOR CHILDREN IN PARTICULAR, TO ASK THE PARENTS, "HOW IS YOUR KID ACTING? HAS THEIR BEHAVIOR CHANGED AT ALL? ARE THEY ACTING FUNNY? ARE THEY SLEEPING MORE?" THINGS LIKE THAT.

 

PETER SALGO:

 

ALL RIGHT, SO YOU EVENTUALLY DECIDED TO QUIT RIGHT ABOUT THAT TIME, RIGHT?

 

MONICA COOK:

 

MM-HMM.

 

PETER SALGO:

 

YOU WANTED GOOD GRADES, YOU DIDN'T WANT YOUR BRAIN TO GET MESSED UP.

 

MONICA COOK:

 

YEAH.

 

PETER SALGO:

 

WHAT DO YOU DO NOW?

 

MONICA COOK:

 

NOW I'M IN GRADUATE SCHOOL, AND I'M A COACH NOW.

 

PETER SALGO:

 

SO YOU'RE COACHING SOCCER?

 

MONICA COOK:

 

YES.

 

PETER SALGO:

 

ALL RIGHT, THAT'S GREAT. I WANT TO STOP YOU RIGHT THERE. I KNOW THAT YOU HAD A TURNING POINT IN YOUR LIFE AND YOU ARE HERE TO LOOK FOR A SECOND OPINION, AND WE'RE GOING TO GET THAT FOR YOU, AND I WANT THE PANEL TO STAY RIGHT WHERE YOU ARE TOO BECAUSE WE'LL BE RIGHT BACK TO HEAR THIS SECOND OPINION, BUT FIRST HERE'S THIS WEEK'S "MYTH OR MEDICINE."

 

NARRATOR:

 

AN ATHLETE SUFFERS A BLOW TO THE HEAD. HE MAY HAVE A CONCUSSION. AFTER GOING TO THE HOSPITAL, HE GETS A CAT SCAN THAT COMES BACK NORMAL. IS HE IN THE CLEAR? A NORMAL BRAIN SCAN RULES OUT A CONCUSSION, RIGHT? IS THAT MYTH OR MEDICINE?

 

DR. JEFF BAZARIAN:

 

"A NORMAL CT SCAN OR A NORMAL MRI RULES OUT A CONCUSSION." THAT'S A MYTH, AND I'M GOING TO TELL YOU WHY. MY NAME IS JEFF BAZARIAN. I'M ASSOCIATE PROFESSOR OF EMERGENCY MEDICINE AT THE UNIVERSITY OF ROCHESTER SCHOOL OF MEDICINE AND DENTISTRY. CURRENTLY THE WAY A CONCUSSION IS DEFINED IS A BLOW TO THE HEAD OR RAPID DECELERATION OF THE HEAD THAT RESULTS IN A BRIEF PERIOD OF BEING KNOCKED OUT; OR NOT REMEMBERING, WHICH WE CALL AMNESIA; OR BEING CONFUSED. SO IT'S ONE OF THOSE THREE THINGS THAT WILL GET YOU A DIAGNOSIS OF A CONCUSSION. THERE'S NO LAB TEST OR X-RAY. IT'S BASED SOLELY ON THOSE SYMPTOMS. THERE'S PROBLEMS WITH THAT, OBVIOUSLY, BECAUSE IF PEOPLE CAN'T REMEMBER WHAT HAPPENED, THAT MAKES IT HARD FOR DOCTORS TO DIAGNOSE WHETHER YOU'VE HAD A CONCUSSION OR NOT. BUT UNFORTUNATELY IN 2013 THAT'S WHAT WE HAVE.

 

NARRATOR:

 

DUSTIN, FROM RALEIGH, NORTH CAROLINA, ASKS, "IF A CAT SCAN DOESN'T RULE OUT A CONCUSSION, WHY GET ONE?"

 

JEFF BAZARIAN:

 

IN A SMALL PERCENTAGE OF PEOPLE THAT HAVE CONCUSSION, THERE CAN BE BLEEDING IN THE BRAIN. IT'S NOT POSSIBLE TO TELL WHO'S GOT BLEEDING IN THE BRAIN JUST BY THOSE SYMPTOMS OF LOSS OF CONSCIOUSNESS AND AMNESIA ALONE. THAT'S WHY IT'S IMPORTANT TO GET A CAT SCAN, AND IT'S HARD TO KNOW WHO NEEDS A CAT SCAN WITHOUT ACTUALLY GOING TO A DOCTOR IN AN EMERGENCY ROOM OR TALKING TO YOUR DOCTOR ON THE PHONE TO MAKE THAT DETERMINATION. EVERY CONCUSSION HAS THE POTENTIAL FOR THIS LIFE-THREATENING BLEEDING IN THE BRAIN THAT CAN ONLY BE DETECTED WITH A CT SCAN OR MRI. AND THAT'S MEDICINE.

 

NARRATOR:

 

NOT SURE IF IT'S MYTH OR MEDICINE? CONNECT WITH US ONLINE. WE WILL GET TO WORK AND GET YOU A SECOND OPINION.

 

PETER SALGO:

 

WE'RE HERE WITH MONICA COOK. MONICA, THANK YOU FOR STAYING WITH US ACROSS THE BREAK. MONICA IS A 24-YEAR-OLD -- GOT THE AGE RIGHT? -- GRADUATE STUDENT, AND YOU HAD A FEW HARD HITS TO YOUR HEAD PLAYING SOCCER, OF ALL GAMES. I MEAN, IT'S SUPPOSED TO BE THIS NON-CONTACT SPORT. I HAVE A FEELING I'M MISINTERPRETING THE WAY SOCCER'S PLAYED.

 

MONICA COOK:

 

YEAH, LOTS OF CONTACT IN THE WOMEN'S GAME.

 

PETER SALGO:

 

YOU'RE NOW AN ASSISTANT COLLEGE COACH, AND YOU'RE NOT ACTIVELY PLAYING, RIGHT? AND YOU QUIT PLAYING BECAUSE YOU DIDN'T WANT ANY MORE HITS TO THE SQUASH.

 

MONICA COOK:

 

RIGHT.

 

PETER SALGO:

 

EXCELLENT. IS THAT A REASONABLE WORRY? I MEAN, IF SHE KEPT GETTING HIT, WAS SHE GOING TO PERHAPS LOSE SOME FUNCTIONAL BRAIN POWER?

 

DR. JULIAN BAILES

 

I THINK IT WAS A GOOD DECISION, GIVEN HER SYMPTOMS.

 

PETER SALGO:

 

WHAT ARE THE SHORT-TERM VERSUS THE LONG-TERM COMPLICATIONS OF CONCUSSIONS?

 

DR. LISA HARRIS:

 

SO, SHORT TERM, YOU CAN HAVE HEADACHES, YOU CAN HAVE NAUSEA, DYSFUNCTION, A LITTLE CONFUSION AND COGNITIVE DYSFUNCTION, AND I'LL TURN IT TO YOU FOR THE LONG TERM, BECAUSE I CAN TALK ALL DAY LONG ABOUT THIS.

 

DR. JULIAN BAILES:

 

WELL, I THINK LONG TERM YOU WORRY ABOUT, DOES AN ATHLETE'S REPETITIVE CONCUSSIONS AND POST-CONCUSSION SYMPTOMS LEAD TO A POTENTIALLY SEASON-ENDING PROBLEM, A POTENTIALLY CAREER-ENDING PROBLEM, WHERE THEY HAVE TO RETIRE, AS SHE ULTIMATELY DID, OR CAN IT AFFECT THEM LATER IN LIFE? CAN THEY END UP WITH CHRONIC HEADACHES OR IN A FEW CASES EVEN CHRONIC BRAIN INJURY TYPE SYNDROME, MORE SO FROM PROFESSIONAL ATHLETES.

 

PETER SALGO:

 

BUT THEY REALLY, THEY GET PAID TO TAKE THESE HITS.

 

DR. JULIAN BAILES:

 

WELL, THEY DO, AND THEY HAVE AN UNPRECEDENTED AMOUNT OF EXPOSURE THROUGH THE YEARS TO THOUSANDS OF HITS.

 

PETER SALGO:

 

I'M REMINDED OF THE PUNCH-DRUNK SYNDROME, WHERE BOXERS TYPICALLY WOULD SIT IN A GYM AFTER A CAREER OF BOXING --

 

DR. JULIAN BAILES:

 

BELIEVED TO OCCUR IN ABOUT 20% OF RETIRED PROFESSIONAL BOXERS.

 

PETER SALGO:

 

TWENTY PERCENT? AND THEY GET POUNDED ALL THE TIME. IN FACT, WHEN THEY GO DOWN ON THE CANVAS, THAT IS A CONCUSSION, ISN'T IT?

 

DR. JULIAN BAILES:

 

ABSOLUTELY.

 

PETER SALGO:

 

THEY GET POUNDED. SO THE LONG TERM, IF YOU KEEP GETTING HIT LIKE THIS, IS LONG-TERM BRAIN INJURY?

 

DR. JULIAN BAILES:

 

THAT'S THE POTENTIAL.

 

PETER SALGO:

 

SO IS THERE A WAY TO SO CONSTRUCT, LET'S SAY, SOCCER, SO THAT YOU DON'T GET THIS? IS IT ALWAYS GOING TO BE A PART OF THIS GAME?

 

DR. LISA HARRIS:

 

I MEAN, THE ONLY WAY TO DO THAT IS TO NOT HAVE CONTACT, WHICH WE DON'T THINK IS GOING TO HAPPEN IN SOCCER OR MANY OF THE OTHER SPORTS THAT OCCUR. I THINK THE IMPORTANT THING IS TO RECOGNIZE THAT -- TO DO EARLY AND QUICK EVALUATION. IF A PLAYER TAKES A HIT, IF THEY FALL, TO NOT ALLOW THE PLAYER TO MAKE THE DECISION WHETHER OR NOT TO ENTER THE GAME. TAKE IT AWAY AND MAKE IT OBJECTIVE AND REALLY ALLOW THEM TO REST.

 

PETER SALGO:

 

I LIKE WHAT YOU SAID. IF A DOCTOR SAYS, "DO YOU WANT TO GO IN," THE ATHLETE IS ALMOST ALWAYS GOING TO SAY YES. THAT CAN'T BE THE SINGLE DETERMINING FACTOR. NOW, YOU STILL HAVE HEADACHES, DON'T YOU? TELL ME ABOUT THOSE.

 

MONICA COOK:

 

I MEAN, I HAVE MILD HEADACHES MAYBE ONCE OR TWICE A WEEK AND SEVERE HEADACHES MAYBE ONCE A MONTH, ONCE EVERY TWO MONTHS OR SO.

 

PETER SALGO:

 

THAT'S A LOT, THOUGH. WHAT HAVE YOU TRIED FOR THAT?

 

MONICA COOK:

 

THROUGHOUT THIS WHOLE PROCESS, I'VE GONE THROUGH A NUMBER OF DIFFERENT TREATMENTS. I'VE TRIED A COUPLE DIFFERENT FORMS OF PHYSICAL THERAPY. I'VE TRIED SOME DIFFERENT MEDICINES. I'VE TRIED CHANGING MY DIET, CHANGING MY EXERCISE. I TRIED ACUPUNCTURE.

 

PETER SALGO:

 

SO, NO SUCCESS WITH ANY OF THIS?

 

MONICA COOK:

 

UM, SOME OF THEM HAD A LITTLE BIT OF HELP KIND OF LIKE RELIEVING SYMPTOMS, BUT I GUESS NO LONG-TERM SUCCESS, NOTHING THAT ELIMINATED THEM COMPLETELY.

 

PETER SALGO:

 

AGAIN, WE TALKED ABOUT THIS AND I MENTIONED IT, YOU TALKED ABOUT MIGRAINE. IS THIS MORE LIKE MIGRAINE, OR DO YOU THINK WE CAN BLAME THIS, CAN YOU BLAME THIS ON A POST-CONCUSSION-LIKE PAIN SYNDROME?

 

DR. LISA HARRIS:

 

WELL, I WOULD CALL IT POST-TRAUMATIC MIGRAINE, WHICH IS A VARIANT.

 

PETER SALGO:

 

IT'S A VARIANT OF POST-CONCUSSION SYNDROME?

 

DR. LISA HARRIS:

 

CORRECT.

 

PETER SALGO:

 

OKAY, SO IT IS RELATED, YOU THINK, TO THE CONCUSSIONS?

 

DR. LISA HARRIS:

 

IT SOUNDS LIKE IT IN TERMS OF WHEN IT BEGAN, AND IT HASN'T STOPPED COMPLETELY SINCE THAT TIME.

 

PETER SALGO:

 

DO THESE THINGS EVER JUST GO AWAY BY THEMSELVES?

 

DR. JULIAN BAILES:

 

THEY CAN, WITH TIME. I THINK THE BRAIN HEALS, AND WHATEVER ONGOING PROCESS IS OCCURRING, WHETHER IT'S CHRONIC INFLAMMATION OR SOMETHING ELSE, WILL SETTLE DOWN, BUT SHE'S STRUGGLED WITH IT, I CAN SEE.

 

DR. LISA HARRIS:

 

PART OF THE ISSUE -- WE'VE GOT TO LET HER BRAIN REST. AND THAT'S NEVER REALLY HAPPENED. SHE WENT THROUGH COLLEGE AND WAS STUDYING ALL THE TIME AND NOW SHE'S IN GRADUATE SCHOOL, AND SHE'S CONTINUING TO UTILIZE HER BRAIN --

 

PETER SALGO:

 

BUT WAIT, LET ME SEE IF I UNDERSTAND WHAT YOU ARE SAYING, THAT USING YOUR BRAIN TO STUDY WILL HURT THE HEALING PROCESS FROM A CONCUSSION?

 

DR. LISA HARRIS:

 

THAT'S LIKE IF YOU BREAK YOUR LEG AND YOU KEEP RUNNING ON IT. THE BONE IS NOT GOING --

 

PETER SALGO:

 

BUT SHE'S NOT HITTING IT INTO A WALL.

 

DR. LISA HARRIS:

 

SHE DOESN'T HAVE TO HIT IT, IT'S THE COGNITIVE FUNCTION.

 

PETER SALGO:

 

IS THAT -- DO YOU AGREE WITH THAT?

 

DR. JULIAN BAILES:

 

WELL, TO SOME EXTENT, YES. THAT'S A DIFFICULT TRADE-OFF IN LIFE, AND THAT'S A DIFFICULT TRADE-OFF FOR STUDENT ATHLETES. IT'S DIFFICULT FOR PEOPLE WHO MAKE A PROFESSION PLAYING ATHLETICS. FOR ANY WALK OF LIFE, IT'S HARD TO PUT YOUR LIFE ON HOLD. SO MANAGING THAT STIMULATION, FOR INSTANCE FOR KIDS, WE DON'T WANT THEM TO PLAY VIDEO GAMES AND HAVE ALL THAT STIMULATION. BUT AFTER A CERTAIN PERIOD OF TIME, IF YOU KEEP THEM OUT OF SCHOOL TOO LONG, IT'S DIMINISHING RETURNS IN SOME CASES.

 

PETER SALGO:

 

SO IT'S A BALANCING ACT.

 

DR. LISA HARRIS:

 

ABSOLUTELY.

 

PETER SALGO:

 

WHERE DO YOU THINK YOU ARE ON THAT? ARE YOU READY NOT TO GO TO SCHOOL FOR A WHILE AND SIT IN A DARK ROOM AND LET YOUR BRAIN HEAL?

 

MONICA COOK:

 

NO. I MEAN, AND THAT'S ONE OF THE REASONS I STOPPED – I DECIDED TO STOP PLAYING BECAUSE I WANTED TO MAKE SURE THAT I COULD FINISH MY DEGREE.

 

PETER SALGO:

 

BUT SHE'S ACTUALLY SAYING FINISHING YOUR STUDIES MIGHT AT LEAST IN PART BE CONTRIBUTING TO YOUR HEADACHES.

 

MONICA COOK:

 

YEAH. WELL, I STARE AT A COMPUTER SCREEN ALL DAY LONG EVERY DAY FOR MY WORK, SO I WOULD IMAGINE THAT THAT WOULD ADD TO --

 

PETER SALGO:

 

WHICH BRINGS US TO THE REASON THAT YOU'RE REALLY HERE, AMONG MANY, BUT YOU'RE HERE FOR A SECOND OPINION. WHAT QUESTIONS WOULD YOU HAVE? WE HAVE GREAT EXPERTS FOR YOU. THIS IS YOUR OPPORTUNITY TO ASK YOUR QUESTIONS FOR A SECOND OPINION.

 

MONICA COOK:

 

YEAH, I'VE STARTED TRACKING MY HEADACHES, SO I WRITE DOWN EVERY TIME I GET THEM AND THE SEVERITY OF THEM. AND IS THIS JUST SOMETHING I SHOULD LIVE WITH AND DEAL WITH? OR WHAT WOULD YOU SUGGEST AS FAR AS SEEKING TREATMENT OR SEEING SOMEBODY?

 

DR. LISA HARRIS:

 

I THINK YOU NEED TO SEE A HEADACHE SPECIALIST AND NOT JUST A NEUROLOGIST OR A NEUROSURGEON, BUT SOMEONE WHO REALLY SPECIALIZES IN HEADACHES AND PARTICULARLY MIGRAINE OR POST-TRAUMATIC MIGRAINE, BECAUSE I THINK THERE ARE SOME TREATMENTS OUT THERE THAT IT DOESN'T SOUND LIKE YOU MAY OR MAY NOT HAVE TRIED. THERE IS SOME PREVENTATIVE THERAPY THAT MAY BE BENEFICIAL TO YOU.

 

DR. JULIAN BAILES:

 

SOUNDS LIKE SHE'S TRIED A LOT, AND I AGREE, YOU'VE MADE A GREAT EFFORT AT TRYING TO OVERCOME THIS, AND I WOULD AGREE THAT A HEADACHE SPECIALIST, ORDINARILY A NEUROLOGIST OR HEADACHE CLINIC, HAS THE MOST EXPERTISE AND CAN MAKE THE MOST PROGRESS. A LOT OF IT IS PART OF LIFESTYLE -- THAT INCLUDES DIET, EXERCISE, SLEEP PATTERNS, HOW YOU MANAGE YOUR WORK AND YOUR SCHOOL AND STUDY RESPONSIBILITIES. BUT PROBABLY THAT'S THE STAGE YOU'RE AT NOW, THAT YOU NEED THAT EXPERTISE.

 

PETER SALGO:

 

DOES THAT SATISFY YOU? DOES THAT ANSWER HELP YOU?

 

MONICA COOK:

 

YEAH, I THINK SO. I JUST WONDER, IS THIS, AM I, SHOULD I EXPECT TO DEAL WITH HEADACHES FOREVER? OR IS IT SOMETHING THAT COULD BE --

 

DR. LISA HARRIS:

 

I WOULD SAY, NO, I DON'T THINK YOU SHOULD EXPECT TO LIVE WITH PAIN FOR THE REST OF YOUR LIFE. I THINK THAT'S SOMETHING THAT CAN BE AGGRESSIVELY --

 

PETER SALGO:

 

I'LL GIVE YOU THE LAST WORD.

 

DR. JULIAN BAILES:

 

I AGREE, I THINK THERE'S OPTIMISM. YOU'RE NO LONGER GETTING THAT STIMULUS OF HITTING YOUR HEAD ALL OF THE TIME, BUT IT'S A COMMITMENT TO GETTING BETTER, WHETHER IT'S MEDICATION OR ALL THE LIFESTYLE THINGS.

 

PETER SALGO:

 

I WANT TO THANK BOTH OF YOU FOR BEING HERE, AND, MONICA, THANK YOU SO MUCH FOR SHARING YOUR STORY, AND I HOPE WE GAVE YOU A SECOND OPINION THAT WAS AT LEAST PARTIALLY HELPFUL. AND NOW FOR THE LAST WORD ON CONCUSSIONS, HERE IS THIS WEEK'S "SECOND OPINION 5."

 

DR. ELIZABETH MURRAY:

 

I'M DR. ELIZABETH MURRAY, AND I'M HERE TO TELL YOU THE FIVE SIGNS OF WHEN TO GO TO THE EMERGENCY ROOM WITH A HEAD INJURY. THE FIRST SIGN IS LARGE BRUISING AT THE SITE OF INJURY. BUMPS AND BRUISES ARE COMMON, BUT A LARGE AMOUNT OF SWELLING OR BRUISING, OFTEN CALLED A GOOSE EGG, ON THE SIDES OR THE BACK OF THE SKULL CAN BE CONCERNING. HOW THE INJURY HAPPENED IS ALSO A FACTOR TO TAKE INTO CONSIDERATION. A FALL FROM STANDING IS ALMOST NEVER GOING TO HURT YOU, BUT A FALL ON A ROCK IS A DIFFERENT SITUATION. INJURIES FROM HARD OR SHARP OBJECTS WILL OFTEN CAUSE THAT BRUISING AND SWELLING WE JUST DISCUSSED. THE THIRD SIGN IS UNCONTROLLED VOMITING. NO ONE WANTS TO FEEL NAUSEOUS OR THROW UP, BUT ONE OF TWO EPISODES OF VOMITING CAN BE COMMON. IT'S THE PERSON WITH UNCONTROLLED VOMITING OR PROFOUND NAUSEA THAT WARRANTS FURTHER EVALUATION. IF YOU'RE EXPERIENCING ALTERED MENTAL STATE OR AMNESIA, THIS IS ANOTHER SIGN TO GET YOU OR YOUR LOVED ONE TO THE EMERGENCY ROOM. CONFUSION IS COMMON FOR A FEW MINUTES AFTER A HEAD INJURY, BUT IF A PERSON IS REPEATING THE SAME QUESTION OVER AND OVER AGAIN OR REALLY SEEMS OUT OF IT, HAVE THEM EVALUATED. AND THE LAST SIGN IS LOSS OF CONSCIOUSNESS OR SEIZURES, AND THIS IS A TRUE MEDICAL EMERGENCY. IF A PERSON IS KNOCKED OUT FOR MORE THAN FIVE SECONDS OR APPEARS TO BE HAVING SEIZURES, THEN YOU NEED TO STAY WITH THEM AND HAVE SOMEONE CALL 911. REMEMBER, YOU KNOW YOUR COMFORT LEVEL BEST, AND YOU KNOW YOUR CHILD BEST. IF SOMETHING SEEMS WRONG TO YOU OR YOU ARE UNCOMFORTABLE, REACH OUT TO YOUR PEDIATRICIAN OR COME SEE US IN THE EMERGENCY DEPARTMENT. AND THAT'S YOUR "SECOND OPINION 5."

 

PETER SALGO:

 

THANK YOU SO MUCH FOR WATCHING "SECOND OPINION." WE HOPE THAT YOU CONTINUE THIS CONVERSATION ON OUR WEBSITE, WHERE YOU CAN COMMENT ON THE SHOW, SEND US YOUR SHOW IDEAS, OR EVEN SHARE YOUR HEALTH STORY WITH US, AND MAYBE WE'LL EVEN INVITE YOU TO BE ON THE SHOW WITH US. THE WEB ADDRESS IS secondopinion-tv.org. I'M DR. PETER SALGO, AND I'LL SEE YOU NEXT TIME FOR ANOTHER "SECOND OPINION."

 

Child: THERE ONCE WAS A TIME WHEN WE WERE TRULY FREE -- FREE OF WORRY, FREE OF FEAR, FAR FROM DOUBT. THAT IS STRENGTH. THAT IS POWER. THAT IS FEARLESS. "SECOND OPINION" IS BROUGHT TO YOU BY BlueCross/BlueShield, ACCEPTED IN ALL 50 STATES. LIVE FEARLESS.

 

NARRATOR:

 

"SECOND OPINION" IS PRODUCED

IN ASSOCIATION WITH

THE UNIVERSITY OF ROCHESTER MEDICAL CENTER,

ROCHESTER, NEW YORK.