
Sports Concussions
Special | 1h 28m 50sVideo has Closed Captions
Playing sports is one of the most common ways a young person can become concussed.
A concussion is a type of traumatic brain injury that happens when the brain is jolted or hit. Short and long term effects can include headaches, dizziness and memory loss. Playing sports is one of the most common ways a young person can become concussed. And while there are risks, there are also protocols to protect the health of athletes.
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KĀKOU - Hawaiʻi’s Town Hall is a local public television program presented by PBS Hawai'i

Sports Concussions
Special | 1h 28m 50sVideo has Closed Captions
A concussion is a type of traumatic brain injury that happens when the brain is jolted or hit. Short and long term effects can include headaches, dizziness and memory loss. Playing sports is one of the most common ways a young person can become concussed. And while there are risks, there are also protocols to protect the health of athletes.
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A CONCUSSION IS A TYPE OF TRAUMATIC BRAIN INJURY THAT HAPPENS WHEN THE BRAIN IS JOLTED OR HIT.
SHORT AND LONG TERM EFFECTS CAN INCLUDE HEADACHES, DIZZINESS AND MEMORY LOSS.
PLAYING SPORTS IS ONE OF THE MOST COMMON WAYS A YOUNG PERSON CAN BECOME CONCUSSED.
AND WHILE THERE ARE RISKS, THERE ARE ALSO PROTOCOLS TO PROTECT THE HEALTH OF ATHLETES.
TONIGHT’S LIVE BROADCAST AND LIVE STREAM OF KAKOU, HAWAII’S TOWN HALL, START NOW.
¶¶ ¶¶ >> YUNJI: ALOHA AND WELCOME TO KAKOU: HAWAII’S TOWN HALL, LIVE FROM THE HARRY AND JEANETTE WEINBERG MULTI‑MEDIA STUDIO.
I’M YUNJI DE NIES.
FROM THE VOLLEYBALL COURTS OF HILO, TO THE FOOTBALL FIELDS OF HONOLULU, SPORTS ARE A CORNERSTONE OF OUR COMMUNITY, BUT WHAT HAPPENS WHEN THE GAME TAKES A DANGEROUS TURN—WHEN THE ATHLETES WHO BRING US PRIDE AND EXCITEMENT FACE AN INJURY THAT COULD IMPACT THEM FOR LIFE?
CONCUSSIONS ARE A GROWING CONCERN ACROSS SPORTS AT ALL LEVELS.
A CONCUSSION IS A BRAIN INJURY, CAUSED BY A BLOW TO THE HEAD OR BODY, THAT CAN DISRUPT NORMAL BRAIN FUNCTION.
IN 2012, HAWAII PASSED ACT 262, A LAW DESIGNED TO PROTECT YOUNG ATHLETES FROM THE DANGERS OF CONCUSSIONS.
UNDER THIS LAW, ANY ATHLETE BETWEEN THE AGES OF 11 AND 19, SUSPECTED OF HAVING A CONCUSSION, MUST BE IMMEDIATELY REMOVED FROM PLAY AND CANNOT RETURN UNTIL CLEARED BY A MEDICAL PROFESSIONAL.
THIS LAW ALSO MANDATES EDUCATION FOR COACHES, PARENTS, AND SCHOOL STAFF TO HELP RECOGNIZE THE SIGNS OF A CONCUSSION AND ENSURE SAFE PLAY.
>> YUNJI: CONCUSSIONS ARE OFTEN INVISIBLE BUT CAN BE DEEPLY IMPACTFUL, WITH LIFELONG CONSEQUENCES.
SO, ARE WE KEEPING OUR ATHLETES SAFE?
AND HOW CAN WE BUILD A STRONGER, MORE INFORMED COMMUNITY WHEN IT COMES TO BRAIN INJURIES IN SPORTS?
THAT’S WHAT WE’RE DISCUSSING TONIGHT.
KAKOU MEANS ALL OF US, AS IN – WE ARE ALL IN THIS TOGETHER.
CONCUSSIONS AFFECT NOT ONLY THE ATHLETES THEMSELVES, BUT ALSO FAMILIES, COACHES, AND COMMUNITIES WHO SUPPORT THEM.
WE WANT TO HEAR FROM YOU IN OUR DISCUSSION.
YOU CAN EMAIL OR CALL IN YOUR QUESTIONS.
WE’RE ALSO STREAMING LIVE AT PBSHAWAII.ORG AND OUR YOUTUBE PAGE.
IN OUR TOWN HALL, WE HAVE ATHLETES, CONCUSSION SURVIVORS, MEDICAL PROFESSIONALS, AND ADVOCATES WORKING TO ENSURE THAT OUR ATHLETES CAN STAY SAFE WHILE PURSUING THE SPORTS THEY LOVE.
SO, LET’S BEGIN.
DR. RACHEL COAL PEDIATRIC SPORTS MEDICINE PHYSICIAN KAPIOLANI BONE AND JOINT CENTER.
CAN YOU TELL US MORE DEEPLY ABOUT WHAT A CONCUSSION SAND HOW THAT PRESENTS IN AN ATHLETE.
>> CONCUSSION TEMPORARY BRAIN INJURY THOUGHT ACCUSE SENSE.
MEANING INITIALLY, WE HOPE AND EXPECT THAT IT SHOULD BE SOMETHING THAT PASSES FAIRLY QUICKLY WITHIN THREE FOUR WEEKS.
HOWEVER, THERE ARE SOME PEOPLE WHO WILL HAVE LASTING SYMPTOMS AND NEED FURTHER TREATMENT.
THE CLASSIC IS A HEADACHE.
IT CAN BE DIZZINESS, LIGHT OR NOISE SENSITIVITY, NAUSEA OR VOMITING.
THREE QUARTERS OF CONCUSSIONS DO HAVE LOSS OF CONSCIOUSNESS, VAST MAJORITY DON'T COME WITH GETTING KNOCKED OUTMENT THOSE THAT DO TAKE A LITTLE BIT MORE SERIOUSLY.
>>Lauren: TYPICALLY HOW LONG DO THESE SYMPTOMS TEND TO RESOLVE?
>> AVERAGE FOR ADOLESCENT 3 TO 4 WEEKS.
TELL MOST PATIENTS EXPECT TO START FEELING BETTER WEEK OR TWO.
LAST UP TO FOUR WEEKS, WILL BE VERY NORMAL.
>>Lauren: BRITTNEY EVANS SPEECH LANGUAGE SCIENCE AND DISORDER JOHNSON A BURNS SCHOOL OF MEDICINE.
WHAT KIND OF COGNITIVE CHANGES CAN HAPPEN IN SOMEONE WHO SUFFERS CONCUSSION TYPICALLY SPEECH LANGUAGE PATHOLOGIST, WE WORK WITH THE COGNITIVE SKILLS, MEMORY MIGHT HAVE TROUBLE WITH THEIR ATTENTION, STAYING FOCUSED IN CLASS.
PROCESSING NEW INFORMATION.
WORD FINDING ISSUES.
SO THOSE ARE SOME THINGS WE CAN KIND OF SUPPORT THEM WITH IN THEIR RETURN TO SCHOOL.
AND LEARNING AND THEIR DAILY LIFE.
>>Lauren: WHAT DOES THAT THERAPY, HOW DO YOU DO THAT?
>> TYPICALLY, IN THE EARLY INITIAL STAGES, STILL RECOVERING REALLY FOCUSING ON COMPENSATORY STRATEGIES AND PROVIDING THEM ACCOMMODATIONS BECAUSE WE DON'T WANT TO OVERLOAD THE BRAIN TOO QUICKLY.
WE MIGHT GIVE THEM, BE ABLE TO WORK WITH THE TEACHERS TO PROVIDE ACCOMMODATIONS FORD CLASSROOM TO MAKE THEIR LEARNING MORE EASY AFTERWARDS, CONTINUING TO HAVE SYMPTOMS, COMPENSATORY STRATEGIES FOR DAILY YOU LIFE.
SO MAYBE LIKE UTILIZING PLANNER MORE, HELP WITH THEIR MEMORY.
OR LIKE WRITING THINGS DOWN, USING AIDS TO STAY MORE ORGANIZED.
WE KIND OF DEVELOPED THOSE GOALS BASED ON WHERE THEIR SPECIFIC SYMPTOMS ARE.
COGNITIVE SYMPTOMS CAN BE SO BROAD.
TAYLOR TO EACH INDIVIDUAL STUDENT.
>>Lauren: DR. JENNIFER KING PEDIATRIC SPORTS MEDICINE PHYSICIAN AT HAWAII PACIFIC HEALTH BONE AND JOINT CENTER.
I'M INTERESTED TO KNOW IF THERE'S A DIFFERENCE YOU SEE IN HOW CONCUSSIONS AFFECT SOMEONE BASED ON AGE?
YOUNG CHILD ADOLESCENT ADULT.
>> WORSE TIME TO GET HE CONCUSSION FRESHMAN YEAR IN HIGH SCHOOL.
SO MUCH TRANSITION HAPPENS AT THAT AGE.
REALLY DIFFICULT FOR THEM TO JUST INTEGRATE BACK INTO SCHOOL.
BECAUSE IT'S ALL NEW TO THEM.
WE WITH TALK ABOUT IT'S REALLY YOUNG AGE GROUPS, ELEMENTARY SCHOOL, WE FIND THAT THEY ACTUALLY DO REALLY WELL BECAUSE THEY HAVE ONE TEACHER.
THEIR ONE TEACHER KNOWS THEM REALLY WELL AND NATURALLY WILL ACCOMMODATE THEM EARLY PHASE OF CONCUSSION UNTIL THEY RECOVER.
>>MIDDLE SCHOOL TRICKY, MULTIPLE TEACHERS SOMETIMES TEACHERS DON'T QUITE KNOW YOU AS WELL, BUT THEY ALSO HAVE SO MANY MORE STUDENTS THAT THEY'RE TAKING CARE OF, IT'S HARD TO REMEMBER BECAUSE THEY DON'T HAVE A SIGN ON THEM THAT SAYS I HAVE A CONCUSSION.
THEN IN THE HIGH SCHOOL AGES, THERE'S A LOT OF SOCIAL THINGS THAT WE'RE DEALING WITH AS HIGH‑SCHOOLERS IN GENERAL.
AND THANK GOODNESS WE HAVE SEGUED WAY FROM THE COCOON THERAPY.
STAY IN DARK ROOM UNTIL FEEL BETTER.
IF YOU'RE A TEENAGER DON'T WANT TO BE ROOM WITH PARENTS 24‑7 ACTIVE MANAGEMENT, HOPING HIGH‑SCHOOLER AND MIDDLE SCHOOLER, RECOVERY WILL BE FASTER.
>>Lauren: CAN YOU TELL US ABOUT COCOON THERAPY AND WHY THERE'S BEEN A TREND IN THE OTHER DIRECTION?
>> ABSOLUTELY.
SO CONCUSSION PENDULUM HAS SWUNG WIDELY.
SO WHEN I WAS IN TRAIN BEING WE SANG KIDS IN SAME DAY, AS LONG AS THEY COULD TELL US WHICH END OF THE FIELD THEY WERE ONE RUNNING TO WANTED TO PLAY.
SEND THEM BACK IN.
LONGTERM EFFECTS WHEN YOU DON'T MANAGE A CONCUSSION, WE NEED TO PROTECT THESE KIDS GET SYMPTOM‑FREE UNTIL WE GET THEM BACK TO SCHOOL TANDEN ANY KIND ACTIVE.
REALIZED IT WAS TAKING LONGER FOR THEM TO RECOVER.
PARTIALLY BECAUSE THEY WEREN'T DOING THEIR NORMAL THINGS.
LOTS OF FOMO, WITH MIDDLE SCHOOL AND HIGH‑SCHOOLERS.
HUGE GAP IN GETTING THEM BACK TO SCHOOL.
THEN SO OF COURSE, EVERY FEW YEARS, NOW CONCUSSION CONSENSUS STATEMENT THAT COMES OUT.
AND THE MOST RECENT ONE, BIGGEST TAKE HOME POINT WAS EARLY RETURN TO ACTIVITY.
OBVIOUSLY NOT BACK TO FOOTBALL GAME.
BUT GOING OUT FOR WALKS, GOING TO THE GROCERY STORE, DOING SOME LIGHT ACTIVITY AS TOLERATED, SO IMPORTANT IN THEIR RECOVERY.
>>Lauren: SEVERAL PEOPLE ON PANEL TONIGHT.
HAVE EXPERIENCED CONCUSSION.
DR. JAMIE HIGA SCHOOL CLINICAL PSYCHOLOGIST EXPERIENCED MULTIPLE CONCUSSIONS COLLEGE BASKETBALL PLAYER.
CAN YOU TELL US ABOUT YOUR INJURIES AND WHAT IS HAPPENED IN THE TIME SINCE?
>> SURE.
YES.
SPEAKING OF COCOON THERAPY, THAT WAS MY ERA OF CONCUSSION MANAGEMENT.
SO MY INJURY WAS IN 2011.
PLAYING BASKETBALL.
AND AT THAT TIME, IT WAS STAY IN THE DARK ROOM UNTIL YOU GET BETTER.
I THINK WE WERE ALL JUST DOING WHAT WE KNEW BEST AT THE TIME.
SO EVEN THAT'S BASKETBALL PRACTICE I WAS STILL PARTICIPATING IN DRILLS AN WHICH IS NOT CONDUCIVE TO POSITIVE RECOVERY.
BUT SINCE THEN, YOU HAVE GRADUATED COLLEGE AND WENT TO GRAD SCHOOL TO BECOME A PSYCHOLOGIST.
DID MY TRAINING IN COLORADO.
RECENTLY MOVED BACK HOME.
>>Lauren: WHO YOU WERE INJURED IN THAT COCOON THERAPY ENVIRONMENT, HOW LONG DID IT TAKE YOU TO RECOVER?
>> THAT'S A TRICKY QUESTION.
I SAY THAT IT'S TRICKY BECAUSE I DON'T KNOW THAT I'VE EVER MADE 100% RECOVERY.
AND SO IT'S HARD TO GIVE US SPECIFIC TIME FRAME ON THAT.
>>Lauren: CASEY WONG PHYSICAL THERAPY SUFFERED SEVERAL CONCUSSION PLAYING SOCCER.
>> HARDEST TIME TO GET A CONCUSSION IS WHEN YOU'RE A FRESHMAN IN HIGH‑SCHOOLER.
WHEN I GOT MY FIRST TWO RECOVERY REALLY ROUGH.
WHOLE YEAR LENGTH'S TIME.
OF PROGRESSING FORWARD AND BACKWARD AND FORWARD AND BACKWARD.
I WAS IN AN ERA A LITTLE BIT OF THE COCOON THERAPY.
RETURN TO PLAYING ABLE TO GO BACK INTO MY SPORT AND HAVING THAT EXPOSURE GETTING BACK OUT THERE SLOWLY.
REALLY SLOW RECOVERY BECAUSE YOU HIGHWAY AT LOT OF SYMPTOMS WITH MY CONCUSSION.
I HAD EVERY ONE THAT YOU COULD PROBABLY LIST ON THE BOOKS INCLUDED HEADACHES, DIZZINESS AND I HAD LOSS OF CONSCIOUSNESS MY FIRST ONE.
AND I HAD THE DOUBLE VISION.
THAT TOOK LONGEST FOR ME TO RECOVER.
SPENT A LOT OF TIME PHYSICAL THERAPY ONE YEAR.
SHAPED WAY WANT TO DO WITH MY LIFE.
WRITING IN FRESHMAN YEAR OF CLASS, WORE DO YOU SEE YOURSELF IN TEN YEARS?
SEE MYSELF PHYSICAL THERAPY TEN YEARS HELPING OTHER PEOPLE THE WAY MAY PHYSICAL THERAPIST HELPED ME.
>>Lauren: HERE YOU ARE.
AS YOU ARE HELPING NOW, PATIENTS WHO ARE GOING THROUGH THOSE SAME THINGS.
WHAT KIND OF PHYSICAL THERAPY CAN BE EMPLOYED TO HELP PEOPLE RECOVER FASTER?
>> I THINK SOMETHING THAT I VALUE IN PHYSICAL THERAPY IS AS WELL AS WHAT I VALUED WHAT I WAS WAS A PATIENT BEING THERE FOR YOUR PATIENT EMOTIONALLY AND PHYSICALLY.
IMPORTANT FOR THEIR RECOVERY TO BE ABLE TO RECOVERY LISTEN WHAT THEY HAVE TO SAY, CONSTRUCT THEIR PLAN OF CARE WANT TO BE HOLISTIC PHYSICAL THERAPY NOT FOCUS JUST PROBLEMS WHAT'S IN FRONT OF ME VERY LIKE I DON'T KNOW THOU SAY IT, BUT VERY STEP‑WISE PROGRESSION SOMETHING THAT MATCHES HOW THEY'RE PROGRESSION.
SOMETHING SIMILAR TO MY CASE AS WELL.
>>Lauren: THANK YOU.
SOPHOMORE KEALAKEHE HIGH SCHOOL HAWAII ISLAND CHEERLEADER.
YOU SUFFERED CONCUSSIONS.
WHAT HAPPENED AND HOW IT'S BEEN SINCE?
YEAH.
I GOT A CONCUSSION LIKE BACK IN AUGUST.
SO SIX MONTHS AGO, FROM CHEERLEADING.
BASE FLYER CAME DOWN AND ELBOWED ME IN THE HEAD.
FINE 24 HOURS.
DOESN'T GET SYMPTOMS UNTIL FIRST DAY OF PRACTICE.
I COULDN'T REALLY SEE.
COULDN'T REMEMBER MUCH OF IT.
EVERYTHING WAS BLURRY GETTING LIGHT‑HEADED DIDN'T REEL REEL OF WHAT WAS HAPPENING.
TOOK A DAY THE TRAINERS CALLED ME DOWN DURING SCHOOL DID A EXAM TEST THING APPARENTLY I FAILED IT REALLY BAD AN THOUGHT I WAS DOING WELL.
TOUGH JOURNEY IN AND OUT OF SCHOOL, STAYING HOME, RESTING, STILL BATTLING SYMPTOMS.
AND IT'S BEEN QUITE A WHILE SO IT'S TOUGH.
>>Lauren: YEAH.
HOW WERE YOU ABLE TO MANAGE THAT AND WHAT KIND OF THERAPIES ARE YOU DOING FOR THAT?
>> I TRIED TO MANAGE IT BY LIKE JUST TAKING THE TIME TO REST WHAT I DON'T FEEL WELL, DOING AS MUCH SCHOOLWORK I CAN WITHOUT OVERWHELMING MYSELF.
TRY TO DO SOME EYE ACTIVITIES AND MEMORY GAMES THAT MY TRAINER HAS PROVIDE ME WITH.
AND MY MOM LIKES TO PLAY WITH ME.
SO IT CAN HELP IMPROVE MY MEMORY AND TRY TO GET MY BRAIN BACK TO NORMAL.
>>Lauren: THANK YOU FOR SHARING THAT.
WE'RE TALKING TO YOU PERSON EXPERIENCED CONCUSSION REEL RELATIVELY RECENTLY SOMEONED ONE LONG TIME.
RICH MIANO FORMER DEFENSIVE BACK.
KNOW VERY WELL PLAYED FOR SEASONS THREE TEAMS IN FOOTBALL TEAM.
SPORTS COMMENTATOR.
HIGHEST LEVEL.
EXPERIENCED ONE CONCUSSION IN THE NFL.
TELL US ABOUT YOUR EXPERIENCE, A LOT OLDER THAN SOME OF THE PREVIOUS PEOPLE ON THIS PANEL.
NFL DURING MY INITIAL DAYS EVEN BACK KAISER HIGH SCHOOL IN 1980, THROUGH THE UNIVERSITY OF HAWAII, THROUGH FIVE YEARS THERE, TO 1985, NATIONAL FOOTBALL LEAGUE FOR 11 SEASONS THROUGH '96, SEEN INCREDIBLE IMPROVEMENTS IN TERMS OF PROTECTION IN TERMS OF HELMETS, PROTECTION IN TERMS OF HAVE TWO A DAY PRACTICES ANY MORE.
DON'T HAVE HITTING DRILLS WE USED TO HAVE.
ALL KINDS OF CHANGES ALL THOSE OTHER THINGS BACK IN THE DAY.
WE JUST WE HIT EACH OTHER WITH OUR HEADS ON CONTINUE BASIS AND THEREFORE, CONCUSSION SOMETHING WE DIDN'T REALLY TALK ABOUT DIDN'T REALLY WANT TO, ADMIT WE HAD SOMETHING THAT NATURE PLAYING SPORT LIKE FOOTBALL.
COLLISION SPORT.
SO MUCH MORE EDUCATION AMONGST COACHES PARTICIPANTS, AMONGST TRAINERS AND WE ARE SO BLESSED STATE OF HAWAII TO HAVE PROBABLY THE BEST IN TERMS OF TRAINING STAFF IN TERMS OF PROTOCOLS, PROCEDURES, THEIR UNDERSTANDING AND KNOWLEDGE WE HAVE HOW SERIOUS CONCUSSIONS ARE, THAT'S TREMENDOUS TO SEE PROGRESSION THROUGHOUT THE DECADES WHERE HE ARE NOW COMPARED TO WHERE WE WERE THE 80s AND 90s.
TWENTY‑FIRST CENTURY.
IT'S ENCOURAGE ME TO BE PART OF THIS PANEL BECAUSE I REALLY FEEL BLESSED TO BE PART OF A STATE THAT CARES SO MUCH ABOUT THE YOUNG ATHLETES AND IT'S COME A LONG, LONG WAY.
AND WE SHOULD BE VERY ENCOURAGED BY THE CONTINUED EDUCATION THAT WE HAVE NEITHER STATE OF HAWAII.
>>Lauren: WHAT YOU'RE TALKING ABOUT, WHAT I'M HEARING YOU SAY, REALLY CULTURE SHIFT IN THE SPORT.
CAN YOU TELL ME ABOUT WHAT YOUR UNDERSTANDING OF HEAD INJURIES AS A PLAYER, WHEN YOU FIRST STARTED, AND NOW, WHERE YOU'VE COME, AND HOW THAT'S CHANGED.
>> LITERALLY YOU IF GOT HIT HARD, THERE WASN'T SOMEBODY IN THE BOX LOOKING.
THERE WASN'T SOMEBODY ON SIDELINE DOCTORS.
YOU HAD YOUR TRAINING STAFF.
WHATEVER AWARE OF THE VIOLENCE OF THIS GAME THAT WE PLAY.
BUT NOBODY REALLY CARED.
THEY JUST WANTED TO MAKE SURE THAT YOU COULD LINE UP AND PLAY THE NEXT SNAP.
DIDN'T CARE ABOUT YOUR SHORT TERM HEALTH OR LONGTERM HEALTH.
I'VE BEEN BLESSED, GO TO GAMES FLORIDA, TO BOSTON UNIVERSITY, TO SAN JOSE, PSYCHOLOGISTS, THIS WHOLE CTE EDUCATION WE'VE LEARNED, FROM THE LAWSUIT, LITIGATION, HAS REALLY INCREASED KNOWLEDGE AND UNDERSTANDING.
AND SO IT'S LIKE I SAID EARLIER, COME SO FAR AND IT'S SUCH A POSITIVE IT THING.
EVEN ITERATIONS OF FIELD TURF, BECOMING SOFTER AND MORE LIKE NATURAL GRASS.
I WAS UNFORTUNATE TO PLAY AT THE UNIVERSITY OF HAWAII IN TERMS OF COOK FIELD AT THE TIME.
THEN AT THE NEW YORK JETS IN ATLANTA FALCONS PHILADELPHIA EAGLES.
PLAYED ON ASTROTURF NOT FIELD TURF A LOT OF INJURIES HAD BECAUSE YOU'RE HITTING YOUR HEAD ON THE SURFACE AS WELL INJURIES HAPPEN WITH THE CONTINUAL CONTACT TYPE OF SPORT THAT WE'RE INVOLVED IN.
SO VERY PLEASED IN THE DIRECTION AND THE KNOWLEDGE AND THE UNDERSTANDING.
>>Lauren: IT IS SUCH A DIFFERENCE YOU'RE DESCRIBING.
ONE OF THE PEOPLE FRONT LINES OF THAT IS BRENT MORIKAMI COACHES GIRL'S SOCCER AND HAWAII RUSH.
WHAT ARE YOU STEPS YOU TAKE TO MAKE SURE YOUR PLAYERS ARE STAYING SAFE NOT HAVING A CULTURE ABOUT WHAT RICH WAS JUST TALKING ABOUT?
>> THINK WE'RE FORTUNATE JUST EDUCATIONAL PIECE.
OUR PLAYERS AND PARENTS ARE WELL AWARE OF CONCUSSIONS HAPPENING NOW.
TOUGH PART TO BE HONEST ON THE SOCCER SIDE OF THINGS THAT HEADING THE BALL IS BIG FACTOR SOCCER COLLISIONS.
THERE'S NO PROTECTION.
BUT THEN HEADING OF THE BALL.
WHEN WE SEE A LOT OF ESPECIALLY ON GIRLS TSI, GETTING CONCUSSIONS BECAUSE OF THAT.
AND SO SOCCER HAS DONE IS THEY'VE ELEVATED AGE IN WHICH KIDS CAN START HEADING BALL.
WHICH ACTUALLY I FEEL LIKE MAKES IT A LITTLE TOUGHER FOR THEM TO START PRACTICING HEADING THE BALL AT OLDER AGE.
SO SCARED OF IT OR WASN'T PART OF THE GAME AT A YOUNGER IT AGE.
SO AS WE SEE PLAYERS AT OLDER AGE ABLE TO HEAD THE BALL, GETTING THEM USED TO THAT AND FEELING CONFIDENT DO THAT WITHOUT GETTING INJURED.
>>Lauren: IS THERE A SAFE WAY TO DO THAT?
DO YOU THINK?
>> THINK HAS TO BE PART OF THEIR TRAINING.
JUST SOMETHING THAT IS IMPLEMENTED IN THE GAME AND PLAYER IS NOT BEING ABLE TO HEAD IT CORRECTLY.
THAT TECHNIQUE CORRECTLY HAS TO BE PART OF PRACTICE.
THEN AGAIN THAT BALANCE OF DOING IT TOO MUCH, BUT DOING IT SO THAT THE PLAYERS ARE COMFORTABLE WITH IT AND USING THE RIGHT TECHNIQUE.
>>Lauren: RICH DID MENTION THAT WE ARE ONE OF THE STATES WITH STRICTEST STANDARDS ONE OF THE PEOPLE AHEAD OF NATHAN.
CONCUSSION MANAGEMENT PROGRAM.
DEAN OF UNIVERSITY OF HAWAII AT MANOA COLLEGE EDUCATION.
TALK ABOUT PROTECTIVE GEAR.
SHOW US TWO HELMETS YOU HAVE AND THE KIND OF DIFFERENCE THAT CAN MAKE?
>> WELL, THE HELMET TECHNOLOGY HAS CLEARED CHANGED OVER DECADE.
HIGH END VARSITY HELMET THAT WAS USED RECENTLY USED.
YOU CAN TELL RECENTLY USED.
THE BASEBALL HELMET HERE IS ALSO WELL USED.
PADDING IN HERE IS WHAT IS THE CUSHION IN HERE THAT WILL PROVIDE YOU IMPACT TO ABSORB SOME OF THE IMPACTS THAT OCCUR.
THIS PARTICULAR HELMET HERE FOR EXAMPLE, WE USE THIS HELMET IN ONE OF OUR STUDIES HERE AT UNIVERSITY OF HAWAII CALLED HOT 808 STUDY.
SENSORS IN THIS HELMET, THAT ACTUALLY MONITORS THE AMOUNT OF IMPACT FROM AND POINT WAS CONTACT ON YOUR HELMET PROVIDES REAL TIME DATA WITH THE PLAYERS PLAYING IMPACTS OCCUR.
TRAINING STATE REQUIRES ATHLETIC TRAINERS IF OUR SCHOOLS BIG THINGS FOR THE STATE AND FOR THE COUNTRY, AND SO THIS ALLOWS US TO HAVE REAL TIME DATA TO MONITOR TYPES OF IMPACTS THAT THE PLAYER HAVE AT VARIOUS POSITION.
TECHNOLOGY CHANGED REAL TIME IMPACTS CAN BE MONITORED ALMOST IMMEDIATELY FOR THE IMMEDIATE REMOVAL OF THE PLAYER EVEN AT PRACTICE.
SO THIS VERY HIGH TECH STUFF.
>>Lauren: THIS KIND OF GEAR CAN'T CHEAP.
TO DO ALL STUDENT ATHLETES HAVE ACCESS TO THIS.
>> NO.
IT'S NOT CHEAP.
WE WERE VERY BLESSED TO HAVE THE GOG FOUNDATION SUPPORT PURCHASING OF THIS HELMET ACROSS THREE DIFFERENT SCHOOLS.
WHAT WE FOUND IS THAT IF YOU WERE THE MONITORING OF HIT, IMPACTS, AND THE ACTUAL RETRAINING OF THE WAY YOU TACKLE, OR BLOCK, WILL CLEARLY DECREASE THE AMOUNT OF IMPACTS THAT THE PLAYER WOULD EXPERIENCE.
OVER THE COURSE OF A SEASON.
SO WE ARE ABLE TO DO THAT.
COMES DOWN TO TRAINING.
COMES DOWN TO EDUCATION AND COMES DOWN TO KNOWING SCIENCE OF HOW TO TACKLE AND HOW TO BLOCK AND ALL OF THOSE THINGS THAT CAN PROTECT YOURSELF.
FROM INJURY.
FUTURE INJURY.
>>Lauren: INTERESTING, ALREADY JUST EARLY ON IN OUR DISCUSSION, WE HAVE EXPLORED HOW IT'S NUMBER OF SPORTS.
IT'S NOT JUST FOOTBALL AS PEOPLE MAY TRADITIONALLY THINK.
HEARD ABOUT CHEERLEADER, SOCCER, BASKETBALL.
VIDEO SHOWS OTHER SPORTS YOU CAN HAVE INJURY.
STARTS WITH FOOTBALL OTHER SPORTS IN THIS VIDEO.
WHERE DO YOU TYPICALLY THESE INJURIES HAPPENING.
>> BIGGER SPORTS IN HAWAII BESIDE FOOTBALL, JUDO.
SURPRISE A LOT OF PEOPLE.
SEE THAT FINE DETAIL NOVICE JUDO ATHLETES WHO ARE NEW TO THE SPORT, EXCITED TO PARTICIPATE MAY NOT KNOW HOW TO LAND PROPERLY PROTECT THEIR HEAD AND NECK AREA ANOTHER SPORT WE SEE A LOT OF CHEERLEADING.
A LOT OF PEOPLE DON'T THINK OF THAT THAT WE CAN SPEAK TO THAT HERE DIRECTLY TONIGHT, BUT IN ADDITION, AGAIN, IT'S OFF OFF SURPRISING FLYING IN THE AIR, BASES OR CATCHING.
SOMETIMES TUMBLING HAPPENS, MISSED THE LANDING.
SEEN IN ALL SPORTS.
SWIMMERS WHO MISREAD FLAGS HIT THE WALL.
SEEN GOLFER HIT BY A CLUB THAT WAS THROWN ACCIDENTALLY BY SOMEBODY ELSE.
SO ACCIDENTS CAN HAPPEN ANY SPORT.
AND WE ALWAYS TELL OUR PATIENTS TO VALIDATE THOSE SYMPTOMS AND MAKE SURE THAT THEY CONNECT WITH THEIR ATHLETIC TRAINER OR THEIR COACH, HAVE ADULT CHECK THEM OUT, DON'T GO BACK IN UNTIL YOU KNOW FOR SURE YOU'RE SAFE.
>>Lauren: DR. KING, STRUCK ME IS THAT SHE WASN'T REALLY AWARE THAT THIS HAD HAPPENED TO HER UNTIL THE NEXT DAY.
HOW COMMON THAT?
>> IT'S PRETTY COMMON.
WE ACTUALLY CALL IT THE MONDAY MORNING CONCUSSION.
TAKE FOOTBALL FOR INSTANCE, BECAUSE THE VOLUME IS HIGH, SOMETIMES YOU'LL SUSTAIN A CONCUSSION FRIDAY NIGHT.
PLAYING FOOTBALL.
BUT THEN YOU KIND OF CRUISE THROUGH THE WEEKEND AND SLEEP, EAT AND KIND OF REST.
THEN YOU GO BACK TO SCHOOL MONDAY MORNING AND YOU HAVE A KILLER HEADACHE.
BECAUSE NOW YOU HAVE TO USE YOUR BRAIN.
NOT UNCOMMON.
I WOULD IMAGINE HAD A CHILL NIGHT AFTER PRACTICE.
HAD TO DO SOMETHING COGNITIVE GAVE HER THE SYMPTOMS.
>>Lauren: WHAT THAT WAS CONVERSATION LIKE?
HARD TO REMEMBER IN THE MOMENT.
REALIZED THIS HAD HAPPEN TO DO YOU, WOULD YOU SURPRISED?
I WAS REALLY SURPRISED.
MOM CALLED ME RIGHT AFTER CLASS, CAN YOU GO DOWN TO THE TRAINERS, PLEASE?
I THINK YOU MIGHT HAVE A CONCUSSION.
NO WAY.
I HAVE A CONCUSSION.
I'M FINE.
I DON'T FEEL ANYTHING WRONG.
FEELING A LITTLE SICK.
WENT DOWN AND DID ALL OF THESE TESTS TOLD ME, HOW I FAILED ALL OF THESE TESTS, THAT KIND OF MAKES SENSE NOW.
>>Lauren: NATHAN TALK ABOUT THOSE PROTOCOLS.
IF WE HAVE THAT HAPPENING, THAT FAR LATER, WE ARE COACHES AND TEACHERS, TRAINERS, TEACHERS TRAINED TO LOOK FOR.
>> TYPICALLY ARE THEY HOPEFULLY DURING THE SCHOOL, PRACTICE DURING THE DAY.
SO HOPEFULLY, THEY ARE WILL BE ABLE TO SEE IT ACTUALLY OCCURRINGER.
THAT'S WHERE EDUCATION FOR THE COACH AND OTHER SUPPORT PERSONNEL THAT ARE THERE EVEN YOUR OWN TEAMMATE, TO MONITOR AND TO ACKNOWLEDGE AND TO RECOGNIZE THAT THERE IS A, MAY BE PROBLEM HERE, TO REPORT IT.
PART OF THE CHALLENGE FOR SOME OF OUR YOUNG PLAYERS IN HIGH SCHOOL NOT WANTING TO REPORT THEIR CONCUSSIONS.
I THINK THAT HAS TO SLOWLY GARNERED SOME ATTENTION.
RECENTLY.
FOR JUST TO PROTECT YOUR OWN TEAMMATE AND PLAYER.
YOUR PLAYERS TO AT LEAST REPORT IT AND KNOWING VERY WELL THAT CHANCE OF THEM RETURNING RIGHT AWAY WILL NOT HAPPEN.
AND THERE'S A LOT AT STAKE FOR SOME OF THESE PLAYERS.
THAT ARE PLAYING HIGH SCHOOL ATHLETICS.
SO WE RECOGNIZE THAT.
WE TRY TO EDUCATE THEM.
TO MAKE SURE THAT QUICKER YOU REPORT IT, QUICKER YOU CAN GET BACK INTO SOME KIND OF PROTOCOL WHICH COULD VARY DEPENDING ON YOUR AGE.
AND DEPENDING SEVERITY ACTUAL IMPACT GET BACK TO SCHOOL AND PLAY AS SOON AS POSSIBLE.
>>Lauren: TALK A LITTLE BIT ABOUT THAT TENSION.
YOU HAVE WORKED AS A COACH.
ABOUT MAKE SURE THE PLAYERS ARE REPORTING THEIR SYMPTOMS.
BECAUSE MAYBE THEY REALLY WANT TO GO BACK THE PLAY THE NEXT GAME.
>> COACHES THEY WANT TO WIN SO BAD, SO MUCH INVESTED INTO BECOMING SUCCESSFUL AT THE COLLEGE LEVEL.
MILLIONS OF DOLLARS.
HIGH SCHOOL LEVEL, PRIDE TO WIN.
BEING A COACH, WANTING TO REPORT A CONCUSSION WHEN YOU KNOW NOT ONLY GOING TO LOSE THAT PLAYER, FOR THIS POTENTIALLY REST OF THIS GAME COULD BE SOME OF THE DOCTORS ALLUDED TO COULD BE A MONTH.
LONGER THAN THAT.
PROBABLY SOME HESITATION AND TREPIDATION REGARDING REPORTING CONCUSSIONS JUST BECAUSE YOU DON'T WANT TO LOSE THAT PLAYER.
I THINK MOST OF THE MOST OF US COACHED IN THIS STATE AND HAVE GOT EDUCATION ON THE SERIOUSNESS AND KNOW THE LONGTERM EFFECTS OF CTE OR ANYTHING ELSE, ALZHEIMER’S DEMENTIA BASED UPON COLLISION SPORT, IT IS BEST TO REPORT THAT AND YOU MAY SUFFER THE CONSEQUENCES OF LOSING THAT PARTICULAR ATHLETE, BUT IT'S MORE IMPORTANT FOR THAT PERSON'S LONG TIME HEALTH.
>>Lauren: DID YOU FEEL PRESSURE TO GO BACK INTO THE SPORT.
YOU HAD SEVERAL CONCUSSION.
DO GO BACK TO GAME PLAY.
DID YOU FEEL THAT TENSION.
>> I WOULD SAY YES BECAUSE I GOT MY SECOND CONCUSSION PRETTY CLOSE TO MY FIRST CONCUSSION.
THAT WOULD BE DUE TO ATHLETIC TRAINER HAVING ME PROGRESS PROTOCOL A LITTLE BIT TOO QUICKLY.
AND SO IMPACT OF RETURNING TO PLAY BECAUSE I WAS ACTUALLY GOALKEEPER.
I NEVER HEADED BALL ONCE IN MY LIFE.
STILL GOT A CONCUSSION.
AND SO IMPACT OF JUST HITTING GROUND FROM DIVING, THAT RESULTED IN MY SECOND CONCUSSION.
THAT'S WHY THE PROCESS OF RECOVERING FROM THAT TOOK SO LONG OF THE TIME FRAME BETWEEN THE FIRST AND SECOND ONE.
>>Lauren: HAVING SUFFERED TWO IN A ROW, WHAT IS THAT DOES THAT DO TO HAVE THEM BACK‑TO‑BACK LIKE THAT?
IMPACT OF THE SECOND ON THE FIRST?
>> YOU KNOW, I DON'T KNOW IF I WOULD KNOW A DIFFERENCE BETWEEN MY EXPERIENCE AND SOMEBODY ELSE'S EXPERIENCE.
>> COMPARING EXPERIENCES IS HARD.
EVERYONE MIGHT HAVE DIFFERENT SYMPTOM OR FEELING.
DEFINITELY, I FELT A LOT SICKER AND FELT A LOT WORSE HAVING THE SECOND ONE I HAD TO GO THROUGH A LOT OF PHYSICAL THERAPY TO HELP WITH THE VESTIBULAR ASPECTS.
DIDN'T HAVE THAT INITIALLY.
ASPECT.
HAD BALANCE ISSUES AND THAT DOUBLE VISION THAT WAS TALKED ABOUT BEFORE.
REALLY HAD AN IMPACT.
>>Lauren: TELL US ABOUT THE IMPACT HAVING CONCUSSION CLOSE TO THE ONE.
SECOND ONE AFTER INITIAL ONE.
>> QUITE A BIT OF RESEARCH SO TO SHOW EFFECTS ADDITIVE.
IF YOU HAVEN'T QUITE FULLY RECOVERED FROM FIRST ONE, HAVE I SECOND ONE, DID RECENTLY RECOVER ONLY BEEN A FEW WEEKS, IMPACT OF THAT SECOND ONE NOT JUST PHYSICALLY ON THE BRAIN, WAY THOSE BRAIN CELLS FUNCTION, CAN BE MUCH MORE SEVERE SECOND TIME AROUND.
SO TYPICALLY, IN OUR PROTOCOLS.
IF WE SEE SOMEBODY HAVE A CONCUSSION COME BACK TO SEE US SHORTLY THEREAFTER, MONTH OR TWO LATER WITH ANOTHER CONCUSSION, WE'RE GOING TO TAKE RETURN TO PLAY PROTOCOL MUCH SLOWER AND REALLY TAKE MORE TIME TO MAKE SURE THEY'RE REALLY WELL.
OFTEN HOLD ATHLETES, FROM THAT PARTICULAR CONTACT SPORT EVEN SIX MONTHS OR A YEAR IF THEY'VE HAD A SERIES OF CONCUSSIONSED.
THREE IN ONE CALENDAR YEAR, HOW MANY IS TOO MANY?
DON'T HAVE THE ANSWER.
BUT WE KNOW THAT THERE'S A PATTERN SHOWN THERE BODY NEEDS A REST.
>>Lauren: STAKE HOLDERS FAMILY TEAM AND FAMILIES.
WE ARE THOSE CONVERSATIONS LIKE WITH PARENT?
PARENTS WANTS TO PUSH THEIR KID IN PLAY OR TAKE THEM OUT?
HOW DO YOU NEGOTIATE THAT PART?
>> I THINK WE ARE WELL‑SUPPORTED HIGH SCHOOL LEVEL.
WITH ATHLETIC TRAINERS AND PROBABLY A LOT MORE STRICT.
AT LEAST CONSCIOUS ABOUT PLAYERS WITH CONCUSSIONS.
AS COACHES WE'RE WELL AWARE AND EDUCATED AS FAR AS CONCUSSIONS BEING VERY PREVALENT AND I THINK WE HAVE TO ADVOCATE FOR THE PLAYERS AS WELL.
LIKE WHAT THE OVER SAID ON THIS PANEL.
OTHER SAID ON THIS PANEL.
MAKE SURE THEY'RE HEALED FULLY, RETURN TO PLAY HAPPEN FASTER A LOT OF TIMES PLAYERS THAT NEED TO TRAVEL, PLAYERS CHAMPIONSHIP, TOURNAMENTS, AND THEM PLUS SOME OF THE PRESSURE FROM THE PARENTS, WANTING TO GET THEM BACK IN THERE.
AND THEN YOU'VE GOT PARENTS THAT ARE A LOT MORE CAUTIOUS.
AND DON'T WANT SON OR DAUGHTER TO RETURN TO PLAY.
VERY QUICKLY.
FOLLOWING PROTOCOLS.
GOT BOTH WAYS.
BUT AS COACHES, JUST TRYING TO FIND THAT MIDDLE GROUND AND LOOK TO EXPERTS LIKE THE DOCTORS TO ADVISE WHAT TO DO NEXT AND THEN AS COACHES, JUST NEED TO IMPLEMENT RETURN TO PLAY PROCESS.
PROTOCOL.
>>Lauren: WE ASKED ABOUT YOUR PERSONAL EXPERIENCE, YOU'RE ALSO A PSYCHOLOGIST WHAT ARE SOME OF THE MENTAL HEALTH IMPACTS OF THESE?
TALKED A LOT ABOUT THE PHYSICAL CHALLENGES THAT CAN RESULT OF THIS.
BUT WHAT ARE SOME OF THE SORT OF MENTAL HEALTH ISSUES THAT CAN COME UP.
>> SO WE DO SEE, ESPECIALLY WITH REPEATED CONCUSSIONS, THREE OR MORE CONCUSSIONS INCREASED RISK FOR ANXIETY, MODERATE TO SEVERE DEPRESSION, AND THEN ALSO, TO ENGAGE IN SELF‑HARM BEHAVIOR.
ADDITIONALLY, IF YOU HAVE A PRE‑EXISTING MENTAL HEALTH CONCERN BASELINE, SO ANXIETY OR DEPRESSION BASELINE, THAT CAN CONTRIBUTE TO LONGER RECOVERY.
>>Lauren: DO WE KNOW WHY THAT IS IT?
>> I DON'T NECESSARILY KNOW IF WE DO.
I WOULD LOVE TO HEAR DR. KING OR DR. KOHL'S THOUGHTS ON THAT.
I THINK PART OF THE CONCEPT WOULD BE AGAIN, CONCUSSION BY DEFINITION IS CELLULAR INJURY.
INJURY.
CHEMICALS.
SO TO SPEAK IN THE BRAIN.
ANYTHING THAT ALREADY TAXES THE BRAIN CHEMISTRY, ADHD, ANXIETY, DEPRESSION, CAR SICKNESS EVEN, THINGS THAT WORK THAT BRAIN HARDER AT BASELINE.
PUT A CONCUSSION ON TOP OF THAT, CHALLENGE THOSE CHEMICALS MORE.
GENERAL THEORY.
>>Lauren: UNDERGOING THROUGH THE SYMPTOMS, CASEY WAS JUST SHARING, ABOUT BEING DIZZY OR DOUBLE VISION, OR FEELING LIKE YOU CAN'T FINE THE WORDS BRITTNEY WAS SHARING WITH US EARLIER, ALL OF THAT HAS TO BE PRETTY FRUSTRATING.
STAND TO REASON THAT YOU WOULD MAYBE GET DEPRESSED ABOUT THAT OR ABOUT THE PACE OF RECOVERY.
>> YEAH ABSOLUTELY.
WE DO CALL CONCUSSION GREAT MAGNIFIER.
WHATEVER IS THERE, GETS MAGNIFIED GREATLY.
AFTER CONCUSSION ANY INJURY, ESPECIALLY WITH TEENAGERS NOT RECOVERED BY FOUR WEEKS.
GOING TO BE ANXIOUS AND DEPRESSED.
WORRIED ABOUT THE TEENAGE NOT.
TYPICALLY WHAT WE WOULD SEE TALK ABOUT ACL INJURIES, CONCUSSION ACROSS THE GAMUT.
WE KNOW GET TO DO THAT FOUR WEEK MARK, IF WE'RE NOT DOING ACTIVITY MANAGEMENT OF WHATEVER THAT INJURY IS, THEY'RE GOING TO GET ANXIOUS AND DEPRESSED.
>>Lauren: HOW LONG CAN KA THAT LAST.
>> UNTIL YOU GET THEM HELP.
EITHER GET RECOVERY, A LOT OF ANXIETY AND DEPRESSION WILL FOLLOW THAT RECOVERY.
ACL INJURY, SET TIMELINE TO RETURN.
IMPLEMENT BEHAVIORAL HEALTH TACTICS OR PLUGGED INTO ADULT.
>>Councilmember Waters: TELL ABOUT YOUR EXPERIENCE.
>>Lauren: TELL US ABOUT YOUR EXPERIENCE WHAT THIS IS HAS BEEN LIKE PHYSICAL LEVEL BUT ALSO MANY OF THE FRUSTRATIONS YOU MIGHT BE FEELING.
>> PHYSICAL LEVEL, IT'S KIND OF HARD BATTLING SYMPTOMS LIKE EVERY DAY.
AND LIKE SCHOOLWORK IT'S LIKE BREAKS YOU DOWN A LITTLE BIT.
MENTALLY, I WANT TO LIKE FEEL BETTER AND NOT HAVE THIS LIKE FEELING ALL THE TIME.
AND THEN ESPECIALLY WHEN SOMETIMES FRIENDS OR PEOPLE ARE LIKE, WHY ARE YOU STILL NOT FEELING WELL?
SHOULDN'T YOU BE BETTER NOW?
ARE YOU SURE?
THAT OR SOMETHING ELSE?
OR LIKE SOMEONE CALLING ME DUMB BECAUSE DON'T HAVE THE SAME INTELLECT ANY MORE.
BECAUSE OF THESE SYMPTOMS.
THE I CAN'T FOCUS AS MUCH AND IT'S HARDER FOR ME TO UNDERSTAND THING.
SO SOME THINGS IT DOES BRING ME DOWN AND SYMPTOMS AND NOT BEING ABLE TO GO BACK TO PLAY, RIGHT AWAY, OR BEING NOT ABLE TO PUSH EVERYTHING OUT THERE LIKE I USED TO, BECAUSE OF IT, IT DOES BRING ME DOWN A LITTLE BIT.
>>Lauren: I WOULD IMAGINE IT WOULD.
SOUNDS REALLY FRUSTRATING.
LET'S GO WITH YOU.
SOME OF THE STRATEGIES WHEN THE KIND OF SYMPTOMS THAT SHE'S TALKING ABOUT CAN'T FIND WORDS OR YOU JUST DON'T HAVE IT RIGHT AS QUICKLY AS YOU DID BEFORE.
WHAT ARE THE TOOLS THAT YOU IMPLEMENT TO GET OF SOME OF THAT BACK?
>> START WITH MOTIVATIONAL INTERVIEWING.
REVIEW NEW CLIENT OR PATIENT, WANT TO KNOW WHAT'S IMPORTANT TO THEM.
WHAT AREAS OF THEIR SPECIFIC LIFE SO WE CAN MAKE SURE WE TAILOR IT TOWARDS THAT.
FOR MEMORY, RESEARCH SPORTS USE OF COMPENSATORY STRATEGIES OR EXTERNAL AIDS WHICH WOULD BE USING YOUR SMARTPHONE TO ORGANIZE THINGS, MAKING SURE YOU WRITE THINGS DOWN AND IMPLEMENTING DAILY HABITS.
SO THEY BECOME ROUTINE.
AND SOMETIMES THAT IS JUST FOR THE SHORT TERM.
TO GET YOU THROUGH THIS HEALING PERIOD.
SOMETIMES PEOPLE USE THAT LONGER.
HEALING PERIOD, KIND OF USE AIDS IN A CERTAIN SENSE, WRITE DOWN DOWN YOUR GROCERY LIST.
IMPLEMENT THAT NOT HAVE TO WORRY SO MUCH ABOUT THE MEMORY AND NOT HAVE TO THAT TAXING SO MUCH.
THEN FOR ATTENTION DRILL BASED THERAPY WE CAN DO.
PRACTICE WITH YOUR SCHOOLWORK OR SOMETHING LIKE THAT.
YOU HAVE TROUBLE PAYING ATTENTION FOR A LONG TIME.
WE MIGHT AMP UP THE AMOUNT OF TIME TO KIND OF SEE HOW THEY THEY RESPOND INCREASE BACKGROUND DISTRACTIONS, DIFFERENT PROGRAMS THAT YOU CAN DO WITH THAT.
SOME EXAMPLES.
>>Lauren: DO WE KNOW COMMON THESE INJURIES DATA TRACKING HOW MANY ATHLETES IN HAWAII OR JUST NATIONWIDE EXPERIENCE CONCUSSION?
>> YES.
SINCE 2010, MAYBE A LITTLE BEFORE THEN, H‑CAMP WAS CREATED, ALONG WITH HELPER DR. COAL AND KING AND OTHERS WERE HE ABLE TO START TO TRACK, BECAUSE OF THE NATURE OF H‑CAMP PROVIDING BASELINE TESTING, PRIOR YOUR SEASON THROUGH SOME KIND OF COGNITIVE TEST ONLINE TYPE SYSTEMS, WE WERE ABLE TO HAVE ALL THE STUDENT ATHLETES, DO BASELINE TESTING PRIOR TO THEIR SEASON.
IF THEY WERE SUSPECTED OF A CONCUSSION, THEY GO BACK ON THE SYSTEM TO DO POST TEST AND SOME COMPARISONS.
LONG STORY SHORT SINCE 2010, TRACK CONCUSSIONS UNTIL BEFORE THE PANDEMIC AND AT HIGH POINT I THINK IN 2013, 2014, WAS ABOUT 1200 CONCUSSIONS ACROSS THE STATE OF HAWAII.
ACROSS ALL PUBLIC HIGH SCHOOLS, ACROSS BOTH CONTACT AND NONCONTACT SPORTS.
THEN ONCE H‑CAMP CAME IN, STARTED TO ACT 262, YOU MENTIONED, THEN THE EDUCATION, TRAINING, AND THE IMMEDIATE REMOVAL ALL OF THOSE CRITERIA PART OF LAW, BEGAN TO BE IMPLEMENTED.
AND THEREFORE, SAW A GRADUAL DECREASE IN CONCUSSIONS OVERALL HERE IN THE STATE OF HAWAII.
SO WE HAVE DATA TO MONITOR, THAT WE MONITOR.
ON ANNUAL BASIS.
AND IT SEEMS TO BE THAT WE ARE, STILL THERE.
IT'S NOT TOTALLY GONE.
BUT WE HAVE A SUGGEST DECREASE IN THE TOTAL OVERALL AMOUNT OF CONCUSSIONS AT THIS POINT.
WE'RE STILL IN THE HUNDREDS.
BUT CONSIDERING STATEWIDE, MALE, FEMALE SPORTS, BOTH CONTACT, NONCONTACT SPORTS, WE SILL STILL HAVE A LOT TO ADDRESS.
>>Lauren: YOU SHOOK YOUR HEAD WITH 1200 NUMBER.
WE LOVE THESE GAMES AND THERE IS SO MUCH TO BE GAINED FROM BEING A PART OF A TEAM AND TO BE ENGAGED IN THESE ATHLETICS.
HOW DO YOU SORT OF WRESTLE WITH THAT?
TRY TO MAKE THAT?
>> WELL, YOU NEVER GOING TO MAKE SPORTS COMPLETELY SAFE.
BECAUSE WHETHER IT'S SOCCER, HEADING BALL, JUST CHANGE THE RULES, OBVIOUSLY FOOTBALL, BEEN SOME RULE CHANGES, AND I'M SURE RULE CHANGES IN OTHER SPORTS TO MAKE IT SAFER, IT'S JUST KIND OF PART OF LIFE AND HOW YOU DEAL WITH IT.
NOT TO PATRONIZE THE PANEL, SO BLESS IN THE STATE TO SO MANY PEOPLE NOT ONLY CONCERNED ABOUT POTENTIAL HEAD INJURIES HAVE KNOWLEDGE WITH HEAD INJURIES LIKE MYSELF, WITH YOU LOOK AT NFL DOES NOT WANT TO PLAY FIELD TURF.
DON'T WANT TO PLAY ON ANY KIND OF ASTROTURF.
SYNTHETIC SURFACE.
REASON WHY STADIUM ARE LIKE THAT BECAUSE THEY'RE MULTIPURPOSE STADIUMS FOR CONCERTS DIFFERENT SPORT AND DIFFERENT EVENTS.
GRASS ISN'T OBVIOUSLY SAFER THAN MOST FIELD TURF, OR ANY TYPE OF SYNTHETIC SURFACES BUT THAT'S GOOD GRASSES.
LOOK AT THE STATE OF HAWAII, SEE SOME OF THESE FIELDS THAT THESE KIDS PLAY ON, IT'S AS HARD AS A ROCK.
AND THEN YOU SEE VERY FORTUNATE TO SEE KALANI GET A NEW FIELD TURF AND ONE AT KAISER.
SOME THROUGHOUT WAIANAE HAS A NEW, BUT AGAIN, THOSE THINGS WE'RE DOWN OVER TIME.
HAVE A LIFE SPAN 8 TO TEN YEARS.
CARPET AT YOUR HOUSE.
PADDING GETS LESS.
HARDER.
HITTING HEAD ON THE GROUND.
WE HAVE TO CONTINUE TO TRY TO MAKE THE SURFACE MORE COMPATIBLE TO BE SAFER FOR THESE ATHLETES AS WELL AS EQUIPMENT AND ALL OF THESE OTHER PROTOCOLS THAT WE HAVE.
BUT HAWAII IS IN A GOOD PLACE BUT WE CAN STILL, STILL A LOT OF IMPROVEMENT FOR OUR YOUNG ATHLETES.
>>Lauren: I MEAN, SO INTERESTING THAT YOU SAY THAT BECAUSE EXACTLY WHAT CASEY WAS SHARING WITH US.
DID NOT HEAD ANY BALLS EXACTLY HOW SHE WAS INJURED.
CAN YOU TELL US ABOUT INVESTMENT THAT YOU THINK NEEDS TO BE MADE TO THE FIELDS THEMSELVES AND TO THESE FACILITIES SO THAT THESE THINGS CAN BE PREVENTED?
>> I THINK FOR WHATEVER SPORT, WE'RE INVOLVED IN, ALWAYS LOOKING FOR THE BEST EQUIPMENT, BEST FACILITIES, AND SOCCER COMPLEX OUT AT WAIPIO, 18 FIELDS OUT THERE, AND PRETTY DIFFICULT TO MANAGE.
ALL GRASS.
BUT LIKE, WHAT RICH WAS ALLUDING TO, MAY BE NOT BEST GRASS.
AND SO A LOT OF HIGH SCHOOL DID KIDS USED TO PLAYING FIELD TURF AND BACK OUT AT WAIPIO, PLAYING ON GRASS.
HARD OUT THERE A LOT CONCUSSIONS COME FROM COLLISIONS FALLING ON GROUND OR LANDING ON GROUND.
HEAD THE BALL.
SPECIFICALLY SOCCER IF WE GET THE BEST POSSIBLE GRASS THAT WOULD BE THE BEST CASE MUCH OBVIOUSLY LOTS OF DOLLARS INVOLVED.
>>Lauren: I WANT TO BRING IN THE AUDIENCE.
BEEN GETTING NUMBER OF QUESTIONS FROM YOU AT HOME OF THANK YOU SO MUCH FOR THOSE OF YOU WHO ARE CALLING IN WRITING IN.
LET'S TAKE THIS ONE FOR DR. KING.
IT SAYS, ARE THERE MISCONCEPTIONS ABOUT SPORTS CONCUSSIONS FOR EXAMPLE, IF YOU'RE NOT KNOCKED OUT, IT'S NOT A CONCUSSION?
>> ABSOLUTELY.
SO IT RUNS WHOLE GAMUT NOT KNOCKED OUT IT'S NOT A CONCUSSION.
WE KNOW, MAJORITY OF CONCUSSIONS DON'T HAVE LOSS OF CONSCIOUSNESS.
THE OTHER IS HAPPEN GO TO THE EMERGENCY ROOM AND THEY GET A CT SCAN.
MY SCAN WAS NORMAL.
I'M FINE.
HAVE TO HAVE THE CONVERSATION WHERE THE SCAN IS JUST THE STRUCTURE, BUT THEN CONCUSSION IS ACTUALLY THE FUNCTION OF THE BRAIN.
LOOKING AT A HOUSE, MIGHT LOOK STRUCTURALLY SOUND, BUT INSIDE, TERMITES HAVE HAVE EATEN AWAYED WOOD, ELECTRICITY NOT BE WORKING WHAT HAPPENS WITH THE CONCUSSION.
NOT PLAYING FOOTBALL, SPORTS ARE SAFE.
I'VE HAD OUTRIGGER CANOE PADDLING HIT BY THE AMA GET A CONCUSSION.
>>Lauren: THERE'S A COUPLE HERE.
RELATED TO HERE.
DO THE HISTORY OF CONCUSSION AFFECT WHEN IT'S KUPUNA LATER AND IS THAT AN ISSUE FOR ANY KUPUNA IN GENERAL, FROM CLAUDIO.
ANOTHER CALLER SAYING.
>> IS THERE ANY RESEARCH DONE ABOUT FREQUENT CONCUSSIONS LEADING TO MEMORY ISSUES OR EVEN DEMENTIA IN THE LONGTERM?
WHAT CAN WE EXPECT TO SEE LATER IN LIFE IF WE SUFFER THESE EARLY?
>> I WOULD SAY THOSE ARE THE MILLION‑DOLLAR QUESTIONS.
RESEARCHER STILL WORKING ON RIGHT NOW.
THERE IS EARLY EVIDENCE THAT REPEATED CONCUSSIONS, KEAWALAU THAI THAT NOT ACTUALLY SURE HOW MANY IS TOO MANY.
QUALIFY THAT.
WE DON'T HAVE HARD FAST NUMBER YOU'VE HAD SIX CONCUSSION GOING TO HAVE LONGTERM PROBLEMS.
MAY BE SOMETHING ABOUT THE IMPACT YOU MIGHT HAVE ONE REALLY BAD CONCUSSION.
AND THAT COULD CAUSE YOU LONGTERM PROBLEMS.
THERE IS EARLY EVIDENCE THAT EITHER REPEATED CONCUSSIONS OR JUST THE RIGHT TYPE OF CONCUSSION, YOUR GENETICS PREDISPOSING LONGTERM PROBLEMS.
SUBSET PEOPLE CONCUSSION COULD CAUSE LONGTERM PROBLEMS AGAIN, I DON'T KNOW WHAT NUMBER THAT IS.
WE DON'T KNOW WHAT YEAR THAT MIGHT AFFECT YOU.
I TRY TO HAVE CONVERSATION WITH MY PATIENTS THAT WE WANT TO GATHER AS MUCH EVIDENCE AS WE CAN BUT SAME TOKEN DON'T WANT TO BE FEARFUL OF LIFE.
HAVE TO LIVE.
HAVE FUN.
ENJOY OUR SPORTS.
NOT GOING TO GIVE UP PADDLING FOOTBALL IF THAT'S IT YOUR LOVE HAD ONE CONCUSSION PERHAPS.
IF YOU HAVE FOUR, MAYBE WE SHOULD HAVE THAT CONVERSATION.
>>Lauren: CTE HAS BEEN A DISCUSSION FOR FOLKS AREN'T FAMILIAR.
CAN YOU TELL US ABOUT WHAT WHERE THAT CONVERSATION NOW NATIONAL LEVEL?
>> YEAH.
I GO BACK TO WHETHER IT'S PHILADELPHIA EAGLES REUNION, NEW YORK JETS.
SEE SOME OF MY TEAMMATES LONG TERM EFFECTS CTE.
EFFECTS FROM CONCUSSION.
HEAD TRAUMA OBVIOUS WILL HITTING EACH OTHER IN THE HEAD CONTINUOUSLY IS NOT A GOOD THING FOR YOU LONGTERM.
TALK ABOUT KUPUNA, A LOT OF EVEN MY FORMER TEAMMATES UNIVERSITY OF HAWAII, LATE FIFTIES, EARLY OF SIXTIES, JOKE ALL THE TIME ABOUT MEMORY LOSS AND NOT REMEMBERING WHAT YOU ATE FOR BREAKFAST.
BEEN OVER A BILLION DOLLARS ALREADY UNDER COMPENSATION FOR CTE PARTICIPANTSES IN THE NATIONAL FOOTBALL LEAGUE.
THAT'S A CONTINUAL FUND BECAUSE IT'S SUCH A SERIOUS PROBLEM.
AND IT'S THERE.
IT'S EVIDENT.
AND SAFER WE CAN CONTINUE TO MAKE FOOTBALL OR ANY SPORT, OBVIOUSLY IT'S BETTER BECAUSE IT DOES AFFECT YOUR LONGTERM ABILITY WHETHER IT'S PLAYING WITH YOUR GRANDCHILDREN OR REMEMBERING BASIC COGNITIVE FUNCTIONS.
>>Lauren: QUESTION HERE.
AFTER GETTING CONCUSSION WHEN OKAY TO RETURN TO GAME?
AVERAGE WAIT TIME?
I WOULD IMAGINE VERY INJURY SPECIFIC.
>> INJURY SPECIFIC.
EARLIER MENTIONED NORMALLY GOING THROUGH RETURN TO PLAY, RETURN TO SCHOOL PROTOCOL AROUND 3 WEEKS, 21 DAYS.
DEPENDING ON AGE.
RETURN TO PLAY AFTER CONCUSSION, NOT REALLY RECOMMENDED.
IT'S THAT RECOGNITION.
PLAYER, TEAMMATE OR TRAINER OR COACH CAN RECOGNIZES IT AND HAVE THE PERSON NOT PLAY.
PLAYER OR TEAMMATE, RIGHT AWAY PROBABLY A GOOD THING AS FAR AS ONCE THEY GO INTO THE PROTOCOLAR ER STATE OF HAWAII WE HAVE A CALLED RETURN TO PLAY PROTOCOL.
THAT WILL TAKE YOU 7 DAYS BUT EACH DAY, DO THINGS.
NOT LIKE YOU JUST STAY AT HOME AND LOCK UP.
REALLY EVERY DAY YOU CAN DO YOUR ACTIVITIES.
NOT LIKE SPORTS SPECIFIC ACTIVITY, LITTLE LATER ON IN THE PROTOCOL.
THERE PROTOCOL THERE.
RETURNING TO PLAY RIGHT AWAY IS I BELIEVE IS NOT RECOMMENDED.
>> CLARIFY THAT PROTOCOL STARTS WITH EVEN IF YOU HAVE SYMPTOMS, WE WANT YOU BACK TO SCHOOL.
WE WANT YOU DOING YOUR SCHOOLWORK AT HOME IF YOU HAVE HOMEWORK.
MODIFED, HELP YOU WITH ADJUSTMENTS AND ACCOMMODATION.
SYMPTOMS 2 TO 3 DAYS START WALKING DO THE LAWN, OTHER TASKS GO OUT TO MOVIES WITH YOUR FRIENDS IF YOU CAN TOLERATE IT.
SYMPTOM DRIVEN.
WHERE THIS ACTUAL GETTING BACK INTO MY SPORT ACTUALLY BEGINS, IS NOT BASED ON CERTAIN TIME FRAME.
IT'S NOT ONE WEEK OR TWO WEEK OR THREE WEEKS.
REALLY BASED ON YOUR SYMPTOMS.
>> HOW ARE YOU FEELING?
CRITICAL PIECE.
SYMPTOMS ARE GONE, BACK TO YOUR BASELINE, IF YOU NORMALLY HAVE HEADACHES, BASELINE, CAN'T EXPECT TO YOU BE HEADACHE FREE.
BACK TO NORMAL HEADACHES.
WHEN YOU HIT THAT POINT, THAT IS WE CAN START A PROGRESSIVE RETURN TO YOUR SPORT INCREASING YOUR ACTIVITY AND INVOLVEMENT WITH YOUR TEAM.
>>Lauren: I WANT TO GO BACK TO WHAT RICH WAS SAYING ABOUT THE CTE AND WITH YOU MENTIONED AT SOME POINT, MAYBE STEP BACK FROM YOUR SPORT.
CAN CAN'T NECESSARILY DRAW A CLEAR LINE FROM SOMETHING THAT HAPPENED TO YOU IN YOUR TEENS TO THEN ALZHEIMER'S LATER YEARS WAS AT WHAT POINT DO YOU SORT OF TELL FOLKS, THIS IS ENOUGH.
CHOOSE SOMETHING ELSE?
GREAT QUESTION.
WOULD LOVE TO HEAR DR. KING'S TAKE ON IT TOO.
FOR ME IN MY PRACTICE, SEE IF THERE'S ANY CHANGES.
WHAT I MEAN BY THAT IS YOU MIGHT SAY YOU FEEL NORMAL, BUT IS YOUR TESTING ALSO SHOWING, BRAIN FUNCTION NORMALLY METABOLIC PROBLEM WITH THE BRAINS AND CELLS FUNCTIONING.
DIFFERENT FORMS OF TESTING.
DR. HIGA CAN TALK ABOUT THAT.
NEUROPSYCHOLOGICAL TESTING, TEST NOT ONLY HOW ARE YOU FEELING BUT HOW ARE YOU THINKING, HOW ARE YOU FUNCTIONING?
IF WE SEE DEFICITS THERE, WE'RE NOT READY TO SEND YOU BACK TO SPORT AND WE MAY WANT TO TALK ABOUT THIS MAYBE SOMETHING TAKE UP NONCONTACT SPORT.
ED INTEREST IN TENNIS OR SWIM TEAM OR SOMETHING DIFFERENT WE COULD SHIFT TO.
PIVOT.
LOVE IT HEAR KIND OF OTHER PEOPLE AS TAKE ON IT.
>> SO EXCITE BECAUSE THEY TOUTED THAT THIS RECENT CONCUSSION CONSENSUS STATEMENT WAS GOING TO HAVE RETIREMENT PIECE.
TO KIND OF HELP US WITH GUIDANCES AS FAR AS WITH DO WE RETIRE ATHLETES.
AND OF COURSE, VERY GRAY RETIREMENT NEEDS TO BE INDIVIDUALLY BASED AND NEEDS TO BE TEAM DECISION BASED ON YOUR HEALTH CARE TEAM AND FAMILY AND OWN INDIVIDUAL DECISION.
SO THAT IS KIND OF WHERE WE ARE.
BUT I THINK FOR US, RED FLAGS ARE NOT BACK TO BASELINE, YOU KEEP HAVING SUBSEQUENT CONCUSSIONS WITH LESS FORCE.
SO NOW, YOUR BRAIN CAN'T TAKE AS MUCH FORCE ANY MORE.
TO SUSTAIN MORE SYMPTOMS.
THOSE ARE PROBABLY THE TWO BIGGEST ONES WE LOOK FOR.
SEE THINGS OBJECTIVELY, EVEN REPORTING TO US FEEL BACK TO NORMAL NOT DOING THE THINGS THEY WERE ABLE TO DO BEFORE CONCUSSION, STILL WANT THEM TO BE ACTIVE.
WE ARE SOME OTHER INTERESTS WE CAN DO FOR NOW AND MIGHT NOT BE FOREVER.
DON'T KNOW WHAT TIME WILL DO AS FAR AS RECOVERY.
BUT TO GET THEM INVOLVED IN SOMETHING ELSE DURING THE TRANSITION PERIOD.
>>Lauren: LOVE TO HEAR YOUR THOUGHTS.
>> SURE.
JUST TALK ABOUT THAT NEUROPHYCH PIECE.
DR. COLE SPEAKING ABOUT WAS NEUROLOGICAL TESTING A LOT OF TIMES.
WHEN WE SEE STUDENTS OR ATHLETES NOT HAVING THIS TYPICAL RECOVERY COURSE.
2 TO 3 EXAMPLE NEUROPHYCH TESTING.
PAPER/PENCIL TESTING.
A LOT OFF HOUR.
TAXING ON BRAIN.
8 TO 16 HOURS TESTING.
LOOKING AT INTELLECTUAL FUNCTIONING, LOOKING AT, SHORT AND LONGTERM MEMORY, EXECUTIVE FUNCTIONING, SUSTAINED ATTENTION.
MEASURING VARIOUS ASPECTS OF COGNITIVE FUNCTIONING AND SEEING IF THERE ANY DEFICITS.
>>Lauren: HOW LONG AFTER THE INJURY CAN YOU DO THAT KIND OF TESTING AND KNOW THAT THERE IS SOME KIND OF RELATIONSHIP?
>> NOT NECESSARILY SPECIFIC TIME FRAME.
BUT WHAT WE WOULD WANT TO SEE IS THAT THE STUDENT HAD ENGAGED IN SOME MEANINGFUL THERAPIES PRIOR.
AND SO MAYBE THIS IS ABOUT SIX MONTHS MAYBE THAT'S A YEAR.
BUT YES, WE WANT TO MAKE SURE THAT WE GAVE ENOUGH TIME FOR THE NATURAL PROGRESSION OF RECOVERY AND THEN ALSO, THE REHAB COURSE AS WELL.
SO THAT PT OR THAT VESTIBULAR THERAPY.
>>Lauren: I WANT TO GO TO YOUR PERSONAL EXPERIENCE BUILDING OFF WHAT RICH WAS SAYING ABOUT PEOPLE EXPERIENCED A LOT OF HEAD TRAUMA.
YOU HAD SAID WHEN I HAD ASKED YOU ABOUT YOUR RECOVERY, YOU'RE NOT SURE THAT WHERE THAT IS.
TELL US A LITTLE BIT ABOUT ARE YOU CONCERNED ABOUT LONGTERM IMPACTS POPPING IN 20, 30 YEARS FROM NOW?
>> I THINK MAYBE BEFORE.
I WAS A LITTLE BIT MORE WORRIED ABOUT IT.
BUT NOW, I THINK, WELL, WHAT HAPPENED IS WHAT HAPPENED IN REGARDS TO THE SYMPTOM.
I DON'T HAVE ANY RESIDUAL SYMPTOMS OTHER PEOPLE HAVE.
SO I FEEL VERY FORTUNATE ASPECT.
I FEEL I HAVE BACK TO NORMAL NO HEADACHES OR DIZZINESS OR ANYTHING I WOULD ATTRIBUT TOWARDS THOSE CONCUSSIONS FROM THE PAST.
FORTUNATE FOR ME, DR. KING HAD ME RETIRE EARLY AFTER THREE CONCUSSIONS, SO I THINK IN THE LONG RUN HELPED ME.
I'M VERY FORTUNATE FOR THAT ASPECT.
>>Lauren: HOW WAS AT THE TIME?
>> REALLY HARD FOR ME AT THE TIME BECAUSE I WAS YOUNG.
THAT WAS 10 YEARS AGO NOW.
WHEN I HAD TO STOP PLAYING SOCCER.
AND YOUNG KID, YOUNG ATHLETE, IN HIGH SCHOOL, SOCCER MEANT EVERYTHING TO ME.
I WAS PLAYING CLUB SOCCER.
FOR LIKE 3 TEAMS I THINK.
SO IT WAS A LOT.
I HAD PRACTICE FIVE DAYS A WEEK.
GAMES 2 DAYS A WEEK.
SOCCER 7 DAYS A WEEK.
PREPARED ME FOR SCHOOL SEASON.
I THINK IT WAS VERY HARD ON MY MENTAL HEALTH AS WE WERE SAYING.
HARDEST PART FOR ME.
WAS THAT MENTAL HEALTH ASPECT OF TAKING SOMETHING AWAY THAT I LOVED SO MUCH.
I THINK IT WAS REALLY HARD TO BECAUSE ALL OF MY FRIENDS WERE INVOLVED IN THE SPORT.
I FELT AT TIMES VERY SAD AND LONELY.
DIDN'T GET TO HANG WITH THEM, SEE THEM THE WAY THAT HE USED TO.
>>Lauren: MUST HAVE BEEN REALLY TOUGH.
SOUNDS LIKE BIG PART OF YOUR IDENTIFY.
>> RIGHT.
STEP ON THE FIELD WITH THE BEST PLAYERS IN THE WORLD.
COMMON THING WHAT DO YOU WANT TO DO WITH YOU GROW UP KIND OF SITUATION I WANT TO BE A PROFESSIONAL SOCCER PLAYER.
>>Lauren: WHERE ARE YOU FEELING ABOUT YOUR SPORT RIGHT NOW?
I KNOW IT'S BEEN SIX MONTHS.
SINCE THE INJURY.
IS IT SOMETHING THAT YOU'RE HOPING TO GET BACK TO OR HOW ARE YOU NAVIGATING THAT.
>> I'M NOT LOOKING FORWARD TO RETURNING TO CHEER LEADING.
NOT ONLY BECAUSE OF MY CONCUSSION, BUT THE WAY MY COACHES AND TEAMMATES HANDLED THINGS.
AND OTHER THINGS THAT HAVE HAPPENED ON TEAM.
I AM LOOKING FORWARD TO DOING RUNNING AND CROSS COUNTRY THINGS LIKE THAT.
BECAUSE IT'S HELPED ME WITH MY INJURY.
I FEEL LIKE I FEEL BETTER AND LESS SYMPTOMS WHEN I RUN.
LOOKING FORWARD TO DOING THAT INSTEAD OF CHEER.
>>Lauren: CAN YOU TAKE THIS ONE FROM KIMO.
KAIMUKI, WITH FOOTBALL AND BASEBALL PLAYERS PATTED ON THE HEAD, INCREASE CONCUSSIONS AND LONGTERM EFFECTS?
HARD PAT ON HEAD?
>> YEAH.
DON'T SEE IT AS MUCH.
IMPACT AND THINK EVERYONE HEAD OR CRANIUM OR BRAIN IS A LITTLE BIT DIFFERENT IN TERMS OF CONTINUOUS HITS TO THE HEAD.
KIND OF SEGUE INTO OFFENSIVE LINEMEN.
DEFENSIVE LINEMEN.
HIT EACH OTHER'S HEAD ALMOST 60 TO 70 TIMES A GAME.
SOMEBODY PLAYS MY POSITION, MAY HIT SOMEONE IN THE HEAD MAYBE FIVE TO TEN TIMES.
IT'S OBVIOUSLY MORE IMPACTFUL TYPE OF IMPACT FROM A SAFETY TO A RUNNINGBACK TO WIDE RECEIVER.
BUT THEY'VE DONE STUDIES AND SEEMS LIKE LINEMEN OFFENSIVE DEFENSIVE LINEMEN, NOT AS SEVERE, CONTINUOUS HITTING TO THE HEAD.
SUFFER ABNORMAL AMOUNT OF CONCUSSION AS WELL.
>>Lauren: I KNOW YOU MENTIONED THAT YOU WERE NOT IN THAT SAME KIND OF POSITION.
NOT AS CONCERNED OR DID NOT SUFFER AS MANY HITS.
DO YOU HAVE THOSE SAME CONCERNS FOR YOURSELF.
>> EVERY DAY I THANK THE LORD PHYSICALLY ABLE TO DO THE THINGS THAT I WANT TO DO IN LIFE.
DO WORRY NEUROLOGICALLY IN TERMS OF BEING ABLE TO BE COGNITIVELY ABLE TO FUNCTION.
SO TREMENDOUS, TREMENDOUS CONCERNS REGARDING THE AMOUNT OF HITS THAT I'VE TAKEN TO MY HEAD.
DELIVERED WITH MY HEAD.
SO IT'S A CONTINUAL BATTLE AND ONE THAT ALMOST CAUSES ISSUES IN TERMS OF NOT DEPRESSION BUT MORE ANXIETY TYPE OF PROBLEMS THAT I THINK OF CONTINUOUSLY.
>>Lauren: OF COURSE, DR. HIGA, REALLY SPEAK TO JUST HAVING SO MUCH UNKNOWN.
>> SURE.
ABSOLUTELY.
I THINK THE UNKNOWN OF THE INJURY MAKES IT REALLY CHALLENGING FOR PEOPLE TO GRASP THEIR HEAD AROUND AND UNDERSTAND WHAT THEIR COURSE OF RECOVERY GOING TO LOOK LOOK.
ANXIETY PROVOKING.
>>Lauren: DR. KING, ABOUT PEOPLE NOT NECESSARILY KNOWING THAT SOMETHING IS STILL WRONG, BECAUSE IT'S INJURY THAT YOU CAN'T NECESSARILY SEE, WHAT KIND OF STRESS DOES THAT ADD FOR PATIENT TO HAVE TO SAY THAT I'M STILL SUFFERING FROM THIS, EVEN IF IT'S NOT OBVIOUS?
>> RIGHT.
IT'S HUGE.
SO I THINK ONE OF THE THINGS WE REALLY THINGS LAY THAT OUT VERY FIRST VISIT TALK ABOUT THE FACT, YOU IF BROKEN BONE, CAST ON EVERYONE KNOWS YOUR INJURED.
DON'T HAVE A CAST ON YOUR HEAD.
NOT KNOW YOU'RE INJURED.
VISIBLE INJURY.
GIVE THEM OWNERSHIP, TALK TO TEACHER TEACHERS AREN'T GOING TO REMEMBER YOU HOOP TO A CONCUSSION.
HARD FOR A FRESHMAN TO SAY, I CAN'T DO THIS WORK RIGHT TERUYA BECAUSE I HAVE A INCLUSION IN MIDDLE OF CLASSROOM TRY TO BUILD SOME STRATEGIES TO HAVE HAND SIGNAL TO THE TEACHER I FORGOT THEY HAVE A CONCUSSION.
THINGS LIKE TO HELP THEM TO SHOW THEY ARE SUPPORTED.
BECAUSE OTHERWISE, IT'S FEELS VERY LONELY TO BE ABLE IN THAT POSITION.
>>Lauren: I WOULD IMAGINE ALSO BECAUSE OF THE NATURE OF THAT, CAN BE ALSO PERHAPS HARD TO ME WHEN YOU FULLY RECOVER.
HOW DO PATIENTS KNOW, WHAT ARE THE METRICS, THERE ARE TESTS THAT YOU APPLY, BUT HOW DO THEY KNOW WHEN THEY'RE ACTUALLY BETTER?
>> ONE THANK ADD TO TESTING FOR SPEECH, STANDARDIZED TESTS AREN'T SPECIFIC COGNITIVE LEVELS BECAUSE OF CONCUSSION.
SO HIGH FUNCTIONING.
NORMAL.
SOMETHING IS WRONG, TRY TO FOCUS ON WHAT THEY'RE TELLING US VERSUS STANDARDIZED TESTING.
OTHER TRICKY PAR IS DOING ANY TIF.
EMOTIONAL SYSTEM IT IS OVERLAP.
NOT GETTING BETTER ANXIETY MIGHT GO DOWN.
COGNITION MIGHT GO UP.
CAN'T FOCUS.
ALL CORRELATED WE'RE ALL ON BOARD WHAT THE SYMPTOMS ARE, TO KIND OF EASE INTO THAT RECOVERY.
AND ANOTHER THING I SEE SOMETIMES IS LIKE WE ALL HAVE THINGS SLIP OUR MIND SOMETIMES.
SOMEBODY MIGHT HAVE SOMETHING HAPPEN WHERE THEY'RE IMMEDIATELY LIKE, OKAY MY GOSH, I HAD A CONCUSSION.
MUST BE FROM THAT.
BRINGING MORE ANXIETY TO THE SITUATION.
TEAM EFFORT MAKING SURE WHAT THEIR BASELINE AND HOW ALL OF THESE THINGS CAN BE SUPPORTED.
>>Lauren: GOES EXACTLY WHAT YOU WERE SAYING.
HOW DO YOU KNOW JUST FORGOT YOUR GROCERY LIST OR SOMETHING YOU NEED TO TAKE MORE SERIOUSLY.
>> I'VE SEEN NEUROPSYCHOLOGISTS IN THE LAST TEN YEARS.
NO BASELINE TESTING IN THE NATIONAL FOOTBALL LEAGUE.
THERE IS IN THE NATIONAL HOCKEY LEAGUE.
YOURSELF AND I THINK KNOW THE ANSWER, CURIOUS.
MAY BE RHETORICAL, DO YOU BASELINE TEST HIGH SCHOOL SPORTS YOU HAVE GOOD.
THAT'S A GOOD THING.
>>Lauren: TELL US ABOUT THAT.
WHAT KIND OF BASELINE TESTING IS DONE.
>> STUDENTS GET A BASELINE TEST IN EITHER SOMETHING CALL AND EVEN COLLEGIAL LEVEL.
COLLEGIATE ATHLETES ALSO GETTING TESTED EITHER IN TESTING CALLED IMPACT OR SOMETHING CALLED SWAY.
AND THESE ARE TESTS AGAIN, THAT DR. HIGA HAD MENTIONED.
COMPUTERIZED BASED ONE.
SIMILARLY TESTING MEMORY.
REACTION TIME.
SOME OF THEM ARE TESTING BALANCE, RECOGNITION.
GOAL OF THIS IS TO HAVE BASELINE SCORE.
SO THAT THEN IF SOMEBODY WERE TO INCUR INJURY, WE CAN COMPARE THE TEST AFTER THEY'VE HAD THE INJURY TO WHAT WE KNOW WAS THEIR FUNCTIONING LEVEL AT BASELINE.
THAT IS IMPORTANT BECAUSE WE ALL HAVE DIFFERENT SKILLS.
AND WHAT I'M GOOD AT, MAY BE DIFFERENT THAN WHAT YOU'RE GOOD AT.
HAVING THAT TEST WE CAN SAY, THEY TESTED THIS WAY BEFORE.
MAYBE THINGS ARE LOOKING GOOD.
I WILL POINT OUT ONE IMPORTANT THING, WHICH IS TESTING IS JUST ONE TOOL IN THE TOOLKIT.
WE DON'T REALLY ON THE TEST TO SAY, THIS IS HOW WE KNOW YOU HAVE CONCUSSION.
OR THIS IS HOW WE KNOW YOU'RE READY TO GO BACK.
I THINK IT'S REALLY IMPORTANT TO TAKE ALL OF THESE THINGS HOW THEY'RE FEELING, WHAT THEIR TESTIMONY IS TO HOW THEY'RE FUNCTIONING, INTO ACCOUNT AS WELL.
I WILL ADD ONE LAST THING.
I WANTED TO ADD.
WAS CAN SHE HAD MENTIONED THAT WE ALSO WANT TO MAKE SURE WE ALWAYS LOOK AT THE FACT THAT SOMETIMES SYMPTOMS AREN'T CONCUSSION.
WE HAD TALKED ABOUT EARLIER.
I THINK THAT IS IMPORTANT BECAUSE I ALWAYS EXPLAIN TO MY PATIENTS, LISTEN, IF I'M ALL OF THESE CONCUSSION TREATMENTS BUT PROBLEM IS SOMETHING ELSE GOING ON.
NOT NOURISHING WELL.
SKIPPING MEALS MOST COMMON SLEEP.
UP ALL NIGHT ON PHONES TEXTING FRIENDS, GO GOING DOWN THE YOUTUBE RABBIT HOLE.
IF WE CAN SLEEP, SYMPTOMS GO AWAY.
WASN'T CONCUSSION.
GIVING THEM HEADACHE.
FIVE HOURS SLEEP A NIGHT.
>> STUDENT ATHLETES THINK CONCUSSION TEST, IT'S A BRAIN TEST NOT REALLY CONCUSSION TEST.
SO REMIND THEM, IF I GIVE IT TO YOU RESIDENT THAT WAS IN THE HOSPITAL ALL NIGHT DIDN'T SLEEP, THEY'RE GOING TO LOOK LIKE THEY HAD A CONCUSSION.
SO WE HAVE TO KEEP IN IN MIND TOO.
SOMETIMES CERTAIN LEVEL OF ANXIETY WHEN THEY CAN'T PASS THE CONCUSSION TEST.
AND THEN WHEN THEY GET THE COACHING ON SLEEP, DON'T BE HUNGRY, MAKE SURE GO TO THE BATHROOM BEFORE YOU TAKE THE TEST, NOT RUSHING THROUGH IT, PERFORM BETTER IN THE END.
>>Lauren: QUESTION HERE FROM ROBERT.
LET'S START WITH YOU.
ARE THE STUDENT ATHLETES EDUCATED ABOUT THE DANGERS OF CONCUSSIONS AND WHAT TO LOOK OUT FOR?
WHAT YOU TOLD THIS WAS A RISK BEFORE YOU ENGAGED IN THE SPORT.
>> YES.
NOTIFIED YEARS BEFORE AM MIDDLE SCHOOL.
MADE ME WATCH VIDEOS ABOUT IT.
I WAS THEN TOLD ABOUT IF MY FRESHMAN YEAR.
WHEN I TOOK THE IMPACT TEST.
THEY WENT THROUGH IT.
IT WASN'T TILL I ACTUALLY GOT MY CONCUSSION THAT I REALIZED WHAT, THE SYMPTOMS WERE.
AND WHAT IT REALLY WAS LIKE.
I FEEL LIKE THEY PROBABLY COULD HAVE DONE A BETTER JOB OF NOTIFYING COACH AND LETTING THEM HAVE A TALK WITH ATHLETES BEFORE GETTING IN THE SPORT.
ABOUT WHAT DANGERS ARE AND HOW CAN YOU GET A CONCUSSION.
>>Lauren: WHAT WAS YOUR EDUCATION LIKE ABOUT CONCUSSION BEFORE YOU HAD ONE.
YOU KNOW, I DON'T THINK IT WAS REALLY EMPHASIZED.
I JUST KNEW BEFORE PLAYING A SPORT WITH SCHOOL, HAD TO TAKE A TEST.
BUT I FIGURED I THINK THEY SAID IT WAS FOR CONCUSSION TEST I ASSUME.
I DIDN'T KNOW REALLY WHAT A CONCUSSION WAS PRIOR TO INJURY.
VERY SIMILAR.
I DON'T THINK OUR EDUCATION WAS THAT GOOD ON IT.
TO BE HONEST.
>>Lauren: WE HAVE PROTOCOLS IN PLACE.
HOW DO WE MAKE SURE THEY'RE IMPLEMENTED IN THOUSANDS STUDENT ATHLETES.
TENS OF THOUSAND ACROSS THE STATE.
SO IT'S HARD TO MAKE THESE UNIFORM.
>> STATE LAW HERE, WITH REGARD TO ACT 262, THAT ANNUAL TRAINING, DOES OCCUR FOR STUDENT ATHLETES, COACHES PARENTS AND STUDENTS.
ANNUAL THING THAT THEY ALL SCHOOLS HAVE TO GO THROUGH.
ALSO THINK, REALLY HOW MUCH DOES THE CONCUSSION EDUCATION OR AWARENESS THUNK REALLY CHANGE OVER THE YEAR AFTER YEAR TREATMENT STRATEGIES MAY CHANGE.
TECHNOLOGY MAY CHANGE SOME OF THE FEEDBACK THAT WE'VE BEEN GETTING FROM SOME OF THE PARENTS AND COACHES IN PARTICULAR, BECAUSE H‑CAMP INSTRUMENTAL IN STARTING IMPACTS BASELINE TESTING, IS THAT THEY SEE, HEAR THE SAME INFORMATION OVER AND OVER AGAIN.
THERE'S NOTHING NEW.
PAY CLOSE ATTENTION MAY BE SOMETHING NEW.
THAT THEY CAN LEARN AND FACT THAT REPORTING IS CRITICAL.
THINGS OF THAT NATURE THAT MAY HAVE NOT HEARD THE FIRST TIME AROUND.
SO THAT IS PART OF OUR LAW HERE.
ALL SCHOOLS GO THROUGH IT AND USUALLY TRAINERS OR THEIR ATHLETIC DIRECTOR OR SOMEONE AT THE SCHOOL WILL HAVE A WORKSHOP OR SOMETHING FOR THE PARENTS AND COACHES TO PARTICIPATE IN.
AND IT GETS MONITORED.
>>Lauren: SOUNDS SPORT AIRLINE SAFETY VIDEO.
SEEN IT AGAIN AND AGAIN DON'T REALLY LISTEN TO THE FLIGHT ATTENDANT WHEN YOU GET ON A PLANE.
MAYBE THERE'S SOMETHING NEW IMPACT TESTING.
MULTIDISCIPLINARY APPROACH TO WHOLE TREATMENT.
RECOGNITION, RETURN TO SCHOOL.
TEST ALONE WON'T CUT IT.
ONE TOOL TO YOUR TOOLBOX, IT'S THE MEDICAL DOCTORS COUNSELORS AT SCHOOL, TEACHERS AND SCHOOLS EVEN SOME OF YOUR CAFETERIA STAFF WORKERS.
TO BE RECOGNIZING KID MAY FALL AT THE SCHOOL AND EXPERIENCE CONCUSSION.
ONE REALLY KNEW WHAT DO OR WHAT IT WAS TAKES THAT VILLAGE TO LOOK AT THIS APPROACH AND.
SHOULD BE EDUCATED AND INFORMED AS TO WHAT HAPPENS.
>>Lauren: LET'S GO TO THE COACH.
HOW DO WE MAKE SURE MESSAGES ARE LANDING?
HOW DO WE MAKE SURE STUDENT ATHLETES AND PARENTS AN IN THE COMMUNITY RECEIVING THAT INFORMATION.
>> HIGH SCHOOL LEVEL, ALL OF STUDENTS AND FAMILIES HAVE TO WATCH THE VIDEOS.
AND UNDERSTAND THAT AND I THINK AS COACHES, IT IS KIND OF OUR RESPONSIBILITY AS WELL TO HELP OUR PLAYERS UNDERSTAND THAT CONCUSSIONS ARE REAL.
AND THAT IT IS OKAY.
IT PART OF THE GAME.
AND ALL INJURIES ARE PART OF GAME.
I THINK.
WHEN PLAYERS GET HURT, THEY DON'T WANT TO REPORT IT.
SAID IN THE BEGINNING SO MUCH AT STAKE JUST GET UNDERSTAND THAT'S OKAY AND THEY'LL GET ANOTHER OPPORTUNITY OR AT LEAST LOOKING OUT FOR THE BETTERMENT OF THEIR ENTIRE LIFE.
SHORT TERM OR LONG TERM.
AND BUT IT IS SCHOOL PROTOCOL TO HAVE THESE STUDENTS AND THEIR FAMILIES WATCH THESE CONCUSSION VIDEOS AND THEY SIGN OFF ON IT.
I KNOW SCHOOLS VARIOUS PROCEDURES DOING ALL AS A TEAM OR VIDEOS ARE JUST POSTED ON THE SCHOOL ATHLETIC WEBSITE.
BUT THE SCHOOLS DO HAVE THESE PROTOCOLS IN PLACE.
>>Lauren: I WANT TO GO BACK TO YOUR EXPERIENCE.
WHETHER YOU WERE IT TOLD THAT YOU SHOULD NOT PLAY ANY MORE.
WAS THAT DECISION YOU GOT TO MAKES A FAMILY OR INDIVIDUAL, OR WAS IT SIMPLY YOU'RE NOT ALLOWED TO PLAY ANY MORE.
>> HOW IT THAT ACTUALLY WORK?
GO TO THE DOCTOR.
>> USUALLY, I FEEL LIKE WE HAVE THE DISCUSSION IN THE ROOM AND I DON'T THINK I WANT TO PLAY ANY MORE.
OKAY, WHAT DOES THIS LOOK LIKE FOR YOU NOW?
HOW ARE YOU FEELING IN SCHOOL?
HOW ARE YOU FEELING ABOUT YOUR SPORT?
AND NOW THAT THIS IS CONCUSSION NUMBER X, DO YOU FEEL LIKE THAT CONCUSSION WAS EASIER TO GET COMPARED TO CONCUSSION NUMBER ONE?
AND SO JUST ASKING A LOT OF QUESTIONS AND IF I REMEMBER CORRECTLY, HAVE TO LOOK AT MY NOTES DON'T REMEMBER FOR SURE U I WANT TO SAY YOU AND YOUR MOM WERE LOOKING I THINK WE'RE DONE WITH SOCCER.
YOU AND YOUR MOM, I THINK WE'RE DONE WITH SOCCER.
I DON'T THINK PEYTON WAS INVOLVED.
>>Lauren: WAS THAT YOUR PARENTS DECISION OR WAS IT REALLY YOUR DECISION?
>> I THINK DR. KING STEPPED OUT OF THE ROOM FOR A SECOND.
MOM JUST TALKED TO ME AND SAID, I THINK THE BEST THAT YOU DON'T PLAY SOCCER ANY MORE.
YEAH, I THINK SO.
THAT WAS OUR AGREED UPON THING.
DR. KING CAME BACK INTO THE ROOM I THINK YEAH, THAT WAS IT.
>>Lauren: WOW.
YOU SAY THIS MANY YEARS LATER GRATEFUL FOR THAT.
>> YES.
>>Lauren: TELL US ABOUT THAT.
>> LOOKING BACK NOW AFTER TALKED ABOUT TODAY, AND LOOKING AT ALL THE OTHER FOOTBALL PLAYERS WHO HAVE IMPACT UPON IMPACT, I'M SURE DIDN'T PLAY FOOTBALL AND I WOULDN'T PLAY FOOTBALL YOU ABOUT WITH THE IMPACT OF LANDING FROM DIVING, CONSTANTLY OVER AND OVER ON THE HARD SURFACE, VERY SIMILAR SITUATION.
SO I'M VERY GRATEFUL TO HAVE LIMITED AMOUNT OF CONCUSSIONS RATHER THAN UNKNOWN.
INFINITE POSSIBLY AFTER MAYBE EVERY DIVE.
IMPACT TO MY HEAD.
>>Lauren: HAVING THOSE CONVERSATIONS, AS A DOCTOR, HAS TO BE HARD FOR ALL THE REASONS CASEY LAID OUT.
SO MUCH PART OF OUR IDENTITY, PLAYED IN THREE CLUBS IN ADDITION TO SCHOOL TEAM.
SOCCER 24‑7 YEARS OF THAT.
RIGHT?
>> RIGHT VERY DIFFICULT.
I THINK AFTER YOU'VE BEEN IN PRACTICE IT FOR A WHILE YOU CAN JUST FEEL THAT SHIFT DEFINITELY FROM THE PARENTS ABOUT HOW IMPORTANT THEIR RANKING OVERALL HEALTH VERSUS SPORTS.
AND IN THE END, LIKE PARENTS WANT THIRD KIDS HAVE TO HAVE GOOD HEALTHY LONG LIFE.
COMES TO SHIFT AND YOU CAN FEEL THAT SHIFT CHANGE WITHIN THE FAMILY, THAT IS USUALLY WHEN I TRY TO SLIDE IN THE CONVERSATION.
AND I THINK BY THAT POINT YOU ARE THERE AND READY I.
MATTER TRYING TO FEEL OUT PARENTS.
I DO, ON THE FLIPSIDE, I HAVE PATIENTS THAT ARE LIKE.
I DON'T CARE.
I WILL DIE BY FOOTBALL.
AND THEN THEY WILL GO TO URGENT CARE AND GET CLEAR TO RETURN TO PLAY.
HAPPENS TOO AND THOSE ARE THE ONES THAT I WORRY ABOUT.
ONE OF MY FAVORITE COLLEGIATE FOOTBALL PLAYERS WHICH IS WHY I DO WHAT I DO, WAS MY FAVORITE SWEETEST GUY ON THE TEAM, AND THEN ENDED UP NOT HAVING A GREAT CAREER IN THE NFL.
>>Lauren: YEAH.
TELL US ABOUT WHAT THOSE CONVERSATIONS ARE LIKE FOR YOU AS A DOCTOR.
>> >> I THINK AS PHYSICIANS WE NEVER ENJOY GIVING BAD NEWS TO PATIENTS OR HAVING THOSE DIFFICULT CONVERSATIONS.
AFTER SO MANY YEARS, YOU DO HAVE SOME PRACTICE READING YOUR AUDIENCE A LITTLE BIT.
SOMETIMES I AM THE BAD GUY AND I AM OKAY WITH THAT ROLE IF THAT MEANS I'M PROTECTING YOU IN THE LONG RUN.
IF RICH HAD THAT THOSE CONVERSATIONS WITH PHYSICIAN YEARS AGO, IT MAY HAVE CHANGED WHAT YOU CHOSE TO DO OR HOW YOU CHOSE TO PLAY.
I TRY TO BE THAT PERSON.
WHERE WITH ALL INTEGRITY, I SPEAK ABOUT THIS IS WHAT I DO KNOW.
THIS IS WHAT WE KNOW IN THE RESEARCH.
THIS IS WHAT WE DON'T KNOW.
BECAUSE OF THOSE UNKNOWNS I DON'T THINK YOU SHOULD GO BACK.
AND I CANNOT IN MY OWN GOOD CONSCIOUS, CLEAR YOU.
YOU ARE WELCOME FOR FIND A SECOND OPINION ENCOURAGE PEOPLE TO DO SO.
I KNOW I'M NOT THE ONLY CONCUSSION PHYSICIAN ON ISLAND.
ONLY A FEW OF US.
I ENCOURAGE THEM TO EVEN SEE DR. KING OR ANOTHER ONE OF OR PARTNERS AND GET ANOTHER OPINION.
ALWAYS WELCOME THAT.
IN THE END, I MAY NOT BE PERSON TO CLEAR YOU.
I THINK WE'VE HIT MY NUMBER.
>>Lauren: THERE'S A QUESTION HERE.
RICH, DIRECTOR SPORTS MEDIA COMMENTARY.
DO YOU THINK SPORTS IMMEDIATE COMMENTARY IMPROVED OR DOWN PLAY IT?
FROM FANS?
SEEMS LIKE YES WE MORE ABOUT IF AND ACKNOWLEDGE IT.
SOCIETY WANT TO SEE PLAYERS KEEP GOING SO MUCH MONEY ON THE LINE.
SO MUCH PRESSURE ON THE PLAYERS.
>> YEAH, I THINK WE'VE BEEN IN THAT SCENARIO KANOA AND MYSELF MANY TIMES, WHEN YOU OBVIOUSLY WANT TO WHEN YOU HEAR OFFICIAL BASICALLY SAY, TARGETING OR HEAR AN OFFICIAL, UNNECESSARY ROUGHNESS, AND THEY EJECT PLAYERS AND THERE'S SOME CONTROVERSY WHETHER THAT WAS A TARGETING CALL OR WHATEVER ELSE, WE TRY AS MEDIA MEMBERS TO ERR ON THE SIDE CAUTION.
TOM BRADY AND OTHER PEOPLE TALKING ABOUT THE GAME BECOME SOFTER WE PLAY AT TIME MORE LIKE GLADIATORS.
BUT IT'S ALL FOR THE SAFETY THE GAME YOU THINK AS MEDIA MEMBERS HAVE TO REALIZE THAT'S SOMEBODY'S CHILD.
SOMEBODY'S FUTURE.
BE SOMEBODY'S HEALTH POTENTIAL.
IF THERE IS IF WE ARE ERRING ON THE SIDE OF CAUTION, GOOD THING.
>>Lauren: QUESTION FROM LAWRENCE.
SCHOOL FORBID A STUDENT PLAYING SPORT FOR THEIR OWN GOOD?
WHAT ROLE DOES SCHOOL HAVE.
>> HIGH SCHOOL LEVELS ATHLETIC TRAINERS HAVE A LOT OF INPUT.
BUT CLEARLY, WE HAVE TO DECISION WITH THE PARENT AND CONSULTING WITH HEALTH CARE PROVIDERS THAT PLAYER MAY OR MAY NOT INTERACT WITH.
SCHOOL LEVEL ALONE, IT WILL BE VERY DIFFICULT FOR THE ATHLETIC DRAIN TRAINER PERSON IN PARTICULAR OR ATHLETIC TRAINER OR TEACHER OR ADMINISTRATOR TO MAKE THAT CALL.
WE WOULD CERTAINLY RECOMMEND THAT THEY SEEK THE PARENTS INPUT ALONG WITH THEIR PRIMARY HEALTH CARE PROVIDER.
IN GETTING THAT ROBUST KIND OF INFORMATION.
IN ORDER TO MAKE THAT INFORMED DECISION.
>>Lauren: WE'VE BEEN FOCUSING A LOT ON IT'S REALLY EXTREME CASE.
FOLKS NEED TO BE PULLED OUT OF PLAY.
BUT WHAT I ALSO HEARD TONIGHT IS THAT THERE ARE A LOT OF PEOPLE WHO GO THROUGH THIS AND CAN RETURN.
IT'S NOT NECESSARILY CAREER ENDING EXPERIENCE.
WHAT HAVE YOU SEEN IN TERMS OF WHAT CAN BE DONE AFTER CONCUSSION THAT THE MAJORITY OF, I WOULD HOPE, MAJORITY OF PATIENTS CAN RECOVER AND DO PLAY, IF NOT SPORT OR ANOTHER ONE.
MAJORITY OF PATIENTS DO FULLY RECOVER.
SO WE'RE KIND OF THAT LIAISON DURING THAT PERIOD TO KIND OF MAKE SURE THEY'RE GETTING THAT SUPPORTS THAT THEY NEED.
PARENTS HAVE LONGER TIME RECOVERING.
PATIENTS HAVE LONGER TIME RECOVERING.
WORK WITH THEM LONGER AND WHO THEY CAN HAVE THE SYMPTOMS EASE AND ACCOMMODATIONS THAT THEY'RE ABLE TO USE IN THEIR DAILY LIFE NORMAL LIVE DAILY LIFE AGAIN.
>>Lauren: WHAT YOU DO SEE RECOVERY MOST PART.
>> I THINK MAJORITY OF PATIENTS DO MAKE A TYPICAL RECOVERY.
THEY DO RETURN TO THEIR BASELINE LEVELS.
THEN THERE ARE SOME THAT HAVE LASTING EFFECTS.
THAT IS WHERE THE COMPENSATORY STRATEGIES COME INTO PLAY.
>>Lauren: I KNOW THAT WE'VE ASKED YOU A LOT WITH YOUR PERSONAL EXPERIENCE.
INTERESTED IN IT CAN YOUR EXPERIENCE PHYSICAL THERAPIST OTHER SIDE.
WHAT IS IT LIKE FOR YOU WHEN YOU HELP SOMEONE THROUGH THIS?
UNFORTUNATELY I HAVEN'T SEEN PATIENTS WITH CONCUSSIONS.
TREATED OTHER THINGS BUT NOT YET.
CONCUSSIONS.
>>Lauren: OKAY.
MAYBE DOWN THE LINE.
>> YEAH.
MAYBE DOWN THE LINE.
>>Lauren: WHAT ABOUT THE TWO DOCTORS?
I WOULD LIKE SOME PERSPECTIVE.
WE HAVE TALKED ABOUT SOME PRETTY EXTREME OUTCOMES.
BUT FOR THE MOST PART, START WITH YOU.
WHAT DO YOU SEE?
>> THE VAST, VAST MAJORITY OF CONCUSSIONS GET WELL.
WITHOUT UNDUE KIND OF INFLUENCE FROM NEEDING THERAPIES, EXTRA EFFORTS, VAST MAJORITY DO WELL IN A TYPICAL TIMELINE 3 TO 4 WEEKS.
PUT OUT THAT INFORMATION, WHILE THIS IS INJURY THAT WE TAKE VERY SERIOUSLY AND WE HAVE CONCERNS OF COURSE, THAT THERE IS GREAT HOPE THAT IF YOU GET A CONCUSSION I DON'T WANT TO PEOPLE SPENDING THEIR ENERGY AND ANXIETY THAT THEY'RE NOT GOING TO GET WELL.
THE VAST MAJORITY OF PEOPLE GET WELL AND THEY DON'T NEED A LOT OF INTERVENTIONS SOMETIMES JUST NEED TO FIX THEIR SLEEP AND LIFESTYLE INVENTIONS.
WELL UNUSUALED.
WELL HYDRATED MANAGE THEIR STRESS.
WELL NOURISHED.
EXERCISE IS WE CALL MEDICINE FOR CONCUSSION.
PART PRESCRIPTION FOR TREATING CONCUSSION EXERCISE.
KEEP IN NONCONTACT.
CARDIOVASCULAR EXERCISE.
2 OR 3 DAYS AFTER THE INJURY.
VAST MAJORITY OF PEOPLE WILL DO GREAT.
>>Lauren: EXACT OPPOSITE COCOON CONCEPT.
WHAT WE'RE SEEING IN THE MAJORITY OF YOUR PATIENTS PUT IT IN PERSPECTIVE.
LAST YEAR BETWEEN THREE OF US SAW 400 CONCUSSIONS IN OUR CLINICS.
TRACK THEM OVER THE PAST TEN YEARS RETIRED FIVE PEOPLE.
REALLY RARE TO RETIRE ATHLETES.
USUALLY WE DO GET THEM RECOVERED AND THAT HAS GROWN OVER THE COURSE OF TIME.
SO YOU USUALLY, WE LOOK FOR WHAT I CALL LITTLE SPEED BUMPS THAT ARE GETTING IN THE WAY OF RECOVERY.
SO SOMETIMES IF THEY NECK SPRAIN IN ADDITION TO THE CONCUSSION ADDRESS THAT PIECE.
OTHERWISE KEEP GET HEADACHES FROM HE NECK PAIN EYE TRACKING IT OFF, AFFECT THEIR READING TAKE NOTES AND IF WE DON'T RETRAIN THAT SYSTEM FASTER, THEY JUST GET FRUSTRATED NOT BEING ABLE TO READ OR TAKE NOTES.
BALANCED TYPE OF ISSUES, GET FRUSTRATE NEVER GOT CAR SICK BEFORE.
GETTING CAR SICK ALL THE TIME.
THAT IS VERY TRAINABLE THING.
I'M SO GLAD BRITTNEY IS HERE BECAUSE OUR MULTIDISCIPLINARYICALLY CLINIC INCLUDES SPEECH LANG THERAPIST.
VESTIBULAR.
GOOD SAYING CONCUSSIONINGS ARE LIKE SNOWFLAKES.
NO TWO THE SAME.
STRATEGIC ABOUT WHAT WE NEED TO ADDRESS AND DO EXPECT FULL RECOVERY.
>>Lauren: GIVEN EVERYTHING THAT WE'VE HEARD HERE TONIGHT WHAT WOULD SAY I DO OTHER STUDENT ATHLETES MAY HAVE EXPERIENCED WHAT YOU EXPERIENCED TONIGHT?
>> I WOULD PROBABLY JUST SAY, GETS BETTER.
YOU'RE NOT GOING TO HAVE IT FOREVER.
MOST OF THE TIME PROBABLY NOT GOING TO HAVE IT FOREVER.
JUST I GUESS, DON'T THINK OF THE BAD SIDE.
LOOK AT THE BRIGHT SIDE.
MORE NEGATIVE YOU THINK ABOUT IT, LONGER IT'S GOING TO LAST.
STAY FRIEND AND FAMILY.
DON'T BE ALONE.
MAKES IT MORE DIFFICULT.
>>Lauren: TALKED ABOUT SOME OF THE HE IMPROVEMENTS SEE IF FIELD AND EQUIPMENT.
WHAT DO YOU SEE MISSING PIECE HERE?
REACH MORE IMPROVEMENTS WHAT ARE WE NOT DOING THAT WE NEED TO.
>> TRICKY YES.
I WOULD JUST SAY TRICK YES TRYING TO GET ATHLETES TO BE AS FIT AS POSSIBLE.
TRICKY QUESTION.
MENTALLY AND PHYSICALLY.
EVERYTHING IS AS STRONG AS IT CAN BE.
KNOW SOMETHING IS NOT RIGHT NEED TO GET CHECK OUT.
NOT THE NECK.
IT IS BRAIN GOING ON, TRYING TO MAKE SURE THAT ATHLETES ARE SLEEPING, ARE THEY EATING WELL.
AND RECENTLY HAD A STUDENT ATHLETE THAT HAD A CONCUSSION, HAD TO TALK TO HER AND THE PARENTS AND MAKING SURE THAT MAKE SURE SHE'S SLEEPING WELL.
EATING WELL BECAUSE I DON'T WANT HER SAYING THAT IS SHE HAS A HEADACHE BECAUSE OF THESE OTHER THINGS.
OTHER FACTORS.
BECAUSE I HAVE HEADACHES.
I HAVEN'T HAD A CONCUSSION.
IN A LONG TIME.
SO JUST MAKING SURE YOU ARE THAT WE'RE TAKING CARE OF OUR BODY AS BEST AS POSSIBLE.
SO WE CAN IDENTIFY WITH SOMETHING IS WRONG.
>>Lauren: THERE'S ANOTHER VIEWER QUESTION HERE.
ED THE DOCTOR.
WITH ATHLETES LIKE SIMONE BILES TALKING ABOUT MENTAL HEALTH, DOES THAT TALK WAY SOME OF THE STIGMA?
INVISIBLE INJURY.
MENTAL HEALTH PIECE IS VERY IMPORTANT.
>> MENTAL HEALTH EVOLVED OF THE INCLINED TO DISCUSS MENTAL HEALTH.
DEPRESSION AND ANXIETY.
SIMONE BILES IS CHAMPION OF THAT.
WONDERFUL.
ESPECIALLY WITHIN THIS REALM OF CONCUSSION AND SPORTS.
WHERE WE TYPICALLY WANT TO SEE OR WE'VE ALLUDED TO.
TOUGH PERSON CULTURE OF SPORTS.
IMPORTANT TO INCORPATE MENTAL HEALTH ASPECT.
>>Lauren: DO THE STATE ROLE APPLY TO BECAME TEAMS OTHER LEAGUE SPORTS OUT OF SIDE OF SCHOOL?
BASEBALL TEAMS.
>> STATE LAW ACT 262 STARTS AGE 11 I THINK TO 19.
SO THAT IS THE YOUTH LEAGUES IS ONE AREA THAT AS FAR AS H‑CAMP IS CONCERNED, REALLY TRYING TO HARD TO REACH, VERY DIFFICULT TO REACH ALL THE ENTIRE YOUTH PROGRAMS ACROSS THE STATE OF HAWAII.
TALKING VERY LIMITED CREW AND RESOURCES.
HOWEVER, WE DO HAVE ONLINE CAPABILITIES THAT PARENTS CAN ACCESS VIA WEBSITE AND THAT'S IS ONE WAY WE'RE ABLE TO AT LEAST GET THEM EDUCATED IN SOME RESPECT.
AS FAR AS LAW IS CONCERNED, LOOKS AT 11.
FROM 11 ON.
BUT THERE IS IT SOME CONCERNS THOU THAT WE'RE LOOKING AT MIDDLE SCHOOLS TO DO THAT IMPACT TESTING.
DOING FEW MIDDLE SCHOOLS HERE.
ARER BUT CLEARLY, YOUNGER AGE WILL CERTAINLY THEY WE WOULD NEED HAVE TO A LOT OF MORE EDUCATION AWARENESS COACHES USUALLY PARENTS VOLUNTEERING WHERE ARE THE WORKERS?
CHILD AND FRIEND.
UP TO SPEED WITH REGARD TO THE LATEST INFORMATION AND THE CONTEXT OF THE CONCUSSIONS.
>>Lauren: YOU'RE RIGHT.
MY SON IS SIX.
PLAYS BASEBALL.
AND WE STARTED IN NINE.
JUST DADS REALLY JUST DEPENDS WHO HAPPENS TO SHOW UP AND BEEN TAUGHT.
>> YOUTH LEAGUES REACHING OUT TO US.
GOING OUT TO DO TRAINING ACROSS THE STATE AND PROVIDING THEM INFORMATION AND IT'S FREE OF CHARGE.
SO THAT'S NOT LIKE THEY HAVE TO PAY ANYTHING.
GO OUT THERE AND AND PROVIDE THAT INFORMATION.
BECAUSE IT'S SO CRITICAL FOR THEM TO RECEIVE IT.
PARTICULARLY ON THE NEIGHBOR ISLANDS.
AS OPPOSED TO JUST NOT BEING OAHU‑CENTRIC.
TRY TO GET OUT THERE TO ALL ISLANDS.
>>Lauren: STRIKES ME HEARING FROM DR. HIGA AND DR. KING AND DR. COLE, THAT IT REALLY, THEN YOU.
IT IS SORT OF THIS MULTIFACETED APPROACH.
THINK OF CONCUSSIONS VERY PHYSICAL.
OBVIOUSLY IT IS.
ALL OF THESE DIFFERENT BAY WAYS TO APPROACH ITER.
SOMEONE INJURED, WHAT DO YOU WANT THEM TO REMEMBER IN TERMS WHAT KIND OF RESOURCES THEY SHOULD SEEK OUT?
>> I THINK LOOK FOR THE THINGS AREN'T JUST PHYSICAL.
HEADACHE, YOU CAN FEEL IT.
VERY OBVIOUS.
NOTICE OTHER THINGS THAT HAVE CHANGE.
LIKE IS YOUR MENTAL HEALTH DIFFERENT?
ARE YOU HAVING MORE TROUBLE IN SCHOOL THAN YOU WOULD BECAUSE YEAH, SOMETIMES PEOPLE DON'T THINK THAT CAN CORRELATE TO A CONCUSSION.
MILD INJURY.
SO IT'S NOT THAT SERIOUS.
US BEING ABLE TO HELP GIVE THOSE EARLY INTERVENTIONS CAN HELP THEM FROM HAVING LIKE A SPIRAL INTO SOMETHING WORSE.
>> I'M INTERESTED, START WITH YOU.
SAME QUESTION THAT I ASK THE COACH.
WHAT DO YOU THINK IS THAT MISSING PIECE?
YOU TALKED ABOUT HOW WELL HAWAII IS DOING.
RELATIVE TO OTHER PLACES.
WHAT COULD WE STILL DO BETTER?
>> I GET IN TROUBLE BECAUSE OPINIONATE THE PERSON.
ESPECIALLY IT COMES TO MEDIA REGARDING YOUTH FOOTBALL.
TACKLE FOOTBALL.
WHAT AGE SHOULD YOU START?
YOU CAN TEACH SOMEBODY TO YOU TACKLE.
IN A LATER STAGE OF THEIR DEVELOPMENT.
SO I JUST FIRMLY BELIEVE THAT YOUNG PEOPLE SHOULD NOT BE HITTING HEADS UNNECESSARILY.
AND FLAG FOOTBALL.
PYLON.
ALL OF THESE THINGS.
THERE ARE CERTAIN PARENTS AND KIDS THAT WANT TO PLAY AT EARLY AGE.
SO IT'S ONE OF THOSE DEALS WHERE COACHES TEACHING PROPER TACKLING, IF THERE'S PROPER PROTOCOLS.
USUALLY NOT A TRAINER, PARENTS USUALLY NOT WELL INFORMED, SO FOOTBALL IS GREATEST GAME IN THE WORLD.
GIVEN ME EVERYTHING THAT I HAVE.
BUT AT THE SAME TIME, YOUTH FOOTBALL LEGISLATION THROUGHOUT COUNTRY AT DIFFERENT AGE, WE'RE VERY TOUGH PHYSICAL STATE AND HAWAII SO PROUD OF ITS KIND OF FOOTBALL UPBRINGING OR WHATEVER ELSE, THAT'S A SENSITIVE ISSUE.
BUT I DO BELIEVE THAT'S UP TO THE PARENT.
BUT BE BE VERY CONCERN AND INFORM AS POSSIBLE CHILD IS TAKING TOO MANY HITS TO HEAD.
YOU SEE SOME KIND OF NEUROLOGICAL ISSUES.
>>Lauren: IS THERE AN AGE THAT YOU THINK IS THE RIGHT THRESHOLD?
>> AGAIN, I PROBABLY HAVE SAID 12 AT CERTAIN TIMES.
TEN, 14.
WHATEVER ELSE.
BUT AGAIN, YOU'RE NOT GOING TO BAN THE SPORT COMPLETELY.
I DON'T THINK IT SHOULD BE BANNED.
MAKE SURE THAT'S TAUGHT PROPERLY.
THERE'S BEEN SO MUCH ADVANCEMENT IS NOT ONLY EQUIPMENT, BUT TACKLING PROCEDURES.
AND PRACTICE PROTOCOLS.
IT'S I THINK EVERY PARENT'S DECISION.
TOUGH DECISION BECAUSE WE DO LOVE THAT SPORT.
AND PEOPLE POLYNESIA IN PARTICULAR, LOVE TO PLAY FOOTBALL.
LOVE THAT PART OF GAME.
>> IDEALLY, FOOTBALL WOULD BE ONE SEASON.
AND NOT ALL YEAR‑ROUND.
THAT WOULD BE THE OTHER THING.
BASQUE ABLE TO PLAY MULTIPLE SPORTS CROSS TRAINS YOU AND DECREASE YOUR RISK OF OVERALL INJURY TO BEGIN WITH.
TODAY, SAW YOUNG ATHLETE THAT HE PLAYS CONTACT FOOTBALL ALL YEAR‑ROUND BECAUSE ONCE ONE LEAGUE FINISHES, THERE'S ANOTHER LEAGUE READY TO START.
INCREASED EXPOSURE OVER TIME.
IF AT ANY AGE, DOING CONTACT FOOTBALL, IT WOULD JUST BE IDEAL THAT'S ONE SEASON.
>>Lauren: GOOD ADVICE.
>> I WOULD SAY IN SHORT TERM, IT'S AS FAR AS WHAT COULD BE DONE, IS TAKING A CONCUSSION SERIOUSLY.
IN OTHER WORDS, IT DOES HAPPEN.
OFTENTIMES, FOLKS WE LEARNED OUR RESEARCH OVER THE YEAR, SOMETIMES UNLESS IT HAPPENS CLOSE TO YOU, VERY CLOSE TO A FAMILY MEMBER, THE SEVERITY OF IT, YOU BEGIN TO REALIZE HOW IMPORTANT IT IS.
SO I THINK THE SERIOUSNESS OF TAKING CONCUSSION CAN DO, IN AS FAR AS HARM, WITHOUT THE PROPER CARE, I THINK IS SOMETHING THAT WE CAN STILL WORK ON.
AND IT'S JUST ABOUT CONTINUOUSLY GOING OUT TO SPREAD THE WORD OF THE IMPORTANCE AND CONTINUED EDUCATE PEOPLE AND PROVIDE NECESSARY CUTTING EDGE INFORMATION THAT WE AT H‑CAMP AN OTHERS WORKING WITH DR. KING AND COLE AND OTHERS, RESEARCH WE'RE GENERATING LOCAL, RESEARCH HERE, CAN BE APPLICABLE STUDENT ATHLETES IN THE STATE OF HAWAII.
>>Lauren: EVERY YEAR NEW CROP OF PEOPLE COMING UP.
EDUCATION HAS TO JUST CONTINUE.
>> IT HAS IT CONTINUE.
YES.
VERY IMPORTANT.
I THINK.
WE'RE HERE FOR THE LONG RUN H‑CAMP IS A ONE RICH WAS SAYING AS FAR AS STATE, RICH WAS SAYING VERY PROGRESSIVE WE ARE VERY MUCH STATE FUND HERE FOR THE LONG RUN.
FOR THE LONG HAUL.
WE'RE THEY'RE HELP.
>>Lauren: THANK YOU SO MUCH.
THANK YOU TO ALL OF YOUR GUESTS FOR BEING TONIGHT.
THANK YOU HOME WROTE IN OR GAVE US CALL PART OF TONIGHT'S HALL.
APPRECIATE IT.
WE’LL BE BACK WITH ANOTHER KAKOU IN APRIL FOCUSING ON THE FUTURE OF FIREWORKS, AFTER THE DEADLY INCIDENT IN ALIAMANU ON NEW YEAR’S EVE.
AERIAL FIREWORKS HAVE BEEN ILLEGAL IN HAWAII FOR YEARS, AND THE DANGERS ARE WELL DOCUMENTED, SO WHY ARE THEY STILL SO RAMPANT?
JOIN US FOR AN IMPORTANT CONVERSATION ON ILLEGAL FIREWORKS.
I’M YUNJI DE NIES, GOOD NIGHT.
ALOHA.
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