Never underestimate a fall

Erin Bruner

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Erin Bruner, 14, never thought that one basketball game would change the whole course of her eighth grade year. Erin has been playing basketball since kindergarten and the game on December 11, 2010 started out no differently than any other game.

During that mid-December game, Erin and the rest of her Springboro Middle School 8th grade girls’ basketball team took the court against Northmont.  Toward the end of the game Erin went up for a rebound.  A girl on the other team grabbed the ball from behind Erin’s head and pulled her to the ground slamming her head on the floor. Erin’s coach was quickly at her side to assess her condition. He immediately took her off the court and had her sit on the sidelines for the rest of the game.

The rest of the day Erin had a severe headache, but at this point did not think the headache could be a sign of something much worse.

“The next day after Erin had the headache for 24 hours straight I decided to take her to Dayton Children’s Urgent Care in Springboro,” says Jodi Bruner, Erin’s mother.

Erin was given an x-ray and the urgent care physician determined that she had a minor concussion. She was advised to take over-the-counter pain medications and to refrain from any activity until the headache got better. If the headache did not go away or if it became worse, the Bruners were to follow up with their family pediatrician.

Toward the end of December Erin’s headache started to get better and her pediatrician said she could resume light activity. Erin went back to basketball practice and played with her new Wii video games that she had received for Christmas.

Everything changed on January 3, 2011 when Erin was to return to school.

Erin’s headache was now worse than any she had ever experienced. She was sensitive to noise and light, and was unable to walk a straight line. Erin did not go back to school that day, but stayed home and slept for almost two days straight.

After two days, when the headache still hadn’t gone away or gotten any better, Jodi took Erin to see their pediatrician who sent them straight to Dayton Children’s for a CT scan.

The CT scan did not reveal any significant damage to Erin’s brain so they were referred to the headache clinic at Dayton Children’s. They began seeing a neurologist Daniel J Lacey, MD, to help Erin manage her headaches.

“Generally CT scans and MRIs do not show any signs of damage related to a concussion because it is usually at such a microscopic level,” says Dr. Lacey. “When a patient comes to see me, I work with them on how to manage their headaches and any other symptoms they might be having. Concussions are unpredictable so the treatment often varies from child to child. Erin’s concussion symptoms became more severe over time because she did not give her brain the amount of time to rest that it needed. ”

“It was a huge relief that we were able to see Dr. Lacey” says Jodi. “Your child is in pain, you don’t know what’s wrong and nothing you’re doing is making any difference. The doctor is always the one you look to for the quick fix and being able to see him made me feel like I was doing something as a parent.”

Dr. Lacey worked with Erin to find a medicine that would work to relieve some of her headaches. When basic over-the-counter migraine medicines didn’t work he began her on two different prescriptions to help prevent her headaches. She was to take one every day for the dull constant pain and the other when she was hit with sharp pains.

 “Dr. Lacey warned us that there is no predictability with concussions. That was a test for us because we are all control freaks,” says Jeff Bruner, Erin’s father.  “You don’t know if this is going to end in two days, two weeks or six months. We had to be patient and realize that it wouldn’t be on our timetable.”

Erin had now missed over two weeks of school and was starting to fall behind in her classes. Dr. Lacey advised her to go back to taking just two classes a day. Erin also began going back to basketball practices where she sat on the bench and supported her team.

“Erin never voiced her frustration,” says Jeff. “Once she was released back to school she attended every basketball practice and every game even though she could not play. She stayed a part of the team.”

Erin continued to see Dr. Lacey every 30 days.  With each visit, if none of her symptoms had become worse, he would allow Erin to incorporate an activity back into her lifestyle

 “His stipulation was always as soon as something gets worse, you stop doing what you are doing” says Jodi. “He was very emphatic about not escalating the headache in anything she did.”

Many times Erin’s headache would get worse when she concentrated for too long, so activities such as going to class or doing homework proved to be very difficult at times.  Her parents hired a tutor and worked with her teachers to make sure she would still be able to get by in her classes.

“Many people think that it is just sports activity that needs to be avoided,” says Dr. Lacey. “However, really any brain activity can cause more damage when it comes to a concussion. Patients such as Erin need to rest their brain and that includes taking it easy when it comes to school and homework. I recommend for patients to break homework into smaller ‘chunks’ instead of trying to work on it for hours at a time.”

Toward the end of the school year Erin was able to go back to taking her full course load. As the summer began, Erin had an appointment with Dr. Lacey to find out what her restrictions would be when it came to summer activities. They were told that she could do anything as long as it didn’t make the headache worse.

On June 10 Erin spent the day hanging out with her friends. When her mother called to check in on her Erin had some surprising news.

“I knew something was different but I couldn’t figure out what,” says Erin. “I then realized that I just didn’t have a headache anymore.”

According to Dr. Lacey it is not uncommon for a headache associated with a concussion to eventually go away on its own. Just like any other injury to the body the brain needs time to heal, so it is critical to allow it to rest after suffering from a concussion.

“The one thing that I would tell other parents is to take this seriously,” says Jeff.  “It was in my competitive nature to want to put Erin back on the court, but you can’t do that in this situation. You just have to wait. You can never underestimate a headache after a fall.”

Erin Bruner and parents
Dr. Lacey with Erin Bruner

 

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