don't worry I don't have a concussion

[adrian_turtle]

I am just thinking about concussions in a general family sort of way. I have a lot of experience of them, and also a lot of experience of downplaying my own head injuries. I thought that was just a matter of not wanting to use up my whining points when I might need them for dealing with migraine or motion-sickness or something else that could be dealt with more usefully. When modern concussion awareness programs started treating injuries like concussions if people were not unconscious for very long, I started reassessing a lot of the falls in my memory.

(That led to weird conversations with neurologists.
"Have you ever had a concussion?"
"Yes."
"How many?"
"I don't know." This can't be that unusual for people with seizures, even non-convulsive seizures like mine are fall risks. But he looked so very surprised.)

For quite a while I looked back on it thought it was just exhausting to deal with my parents' approach to medical emergencies. So I had years of solidly motivated reasoning to convince myself that any head impact I could walk away from must not be a concussion. Then I remembered it wasn't just the kind of exhausting as their, "Oh no! A child has a bad cut! Let us all run around in a panic and shout at everyone who can possibly be shouted at until the ER doctor stitches it up!" (Which is exhausting, and not what the first aid manual means by applying pressure.) It's that AND their belief that people with suspected concussion ought not be allowed to sleep.

A few decades ago, when I was feeling oddly wistful about young athletes growing up with the modern concussion awareness programs, I thought how great it was that they were prescribing more rest as well as diagnosing concussion based on less severe symptoms. Oh well, too bad we didn't know about that back in the 1970s, isn't modern medicine great? It turns out that my mom still believes people with suspected concussion should not fall asleep. She fell and hit her head a few days ago. She didn't want to drive herself to urgent care because she felt dizzy and her vision was kind of blurry, and she didn't want to sit in an uncomfortable waiting room with a terrible headache. But she suspected she might have a concussion so she had to stay awake for 24 hours. After doing so, she called me and said she was fine and I shouldn't worry. I told her that modern best practice was to get some rest after a head injury, ("But this might have been a concussion! I had to stay awake to make sure it wasn't a concussion!") but first phone the doctor to ask if you have one of the symptoms that would need the ER. ("Why should I go to the ER? If they tell me it's a concussion they would just tell me to stay awake for 24 hours and if I do that at home at least it won't hurt my back.")

I'm not sure how I feel about this.

Comments

[otter]

Doin my autistic thing and relating what comes to mind after reading your post:
To my knowledge, I've only had one diagnosed concussion that led to ER visit. But it was 40+ years ago and they seemed a lot more concerned about stitches and abrasions. Concussion was just mentioned casually, in passing. I've since learned more about concussions and how they affect people due to friends and chosen family. One former friend in particular who had frequent ear infections and probably POTS on top of a violently inflicted TBI decades ago. While I knew her, I witnessed at least 2 falls that led to concussion and knew of several more. I often asked her to call the nurse line, if she called me before she'd done at least that. A trip to the ER meant leaving her vulnerable adult children home alone, which was also quite unsafe. I finally had to disengage from that family altogether because I was getting caught in their downward spiral. It's hard. Traumatic for all of us, probably.

[adrian_turtle]

Medical response to concussions has changed so very much in the last 40 years! There has always been a tendency for doctors to focus a lot more on problems they can do something about. They can't put stitches or a cast on a concussion, so once they determine you didn't crack your skull or damage your neck they used to just tell you it would eventually heal on its own. Now they talk about rest protocols and avoiding a second concussion before the first has fully healed, and symptoms of incomplete healing.

Sometimes I look at modern medicine and I'm amazed at how far we've come, and it's obvious because it's something very specific like improved surgical technique or improved meds that cure cancer. But this is just...diagnostics, just understanding, still just amazing.

[evalerie]

Hugs!!

Years ago Jan and I decided that the only option was to disengage from Weird Health Decisions made by older family members, as long as their decisions didn't endanger other people. For example, one older relative didn't believe the family when they told him he was having small absence seizures, so he wanted to continue driving his car and going rowing. The family decided that driving wasn't okay because he could harm other people, but rowing was okay because he was only endangering himself.

That was the rule I followed for a long time. If a person is an adult, then even if they are making a decision that I don't agree with, the only respectful thing that I could do was to let them make that decision anyway.

But then another relative started repeatedly having dangerous falls and going to the emergency room. She would arrive at the hospital all dizzy and confused, stay there for a while, getting regularly scheduled meals and appropriate meds, bounce back, and take herself home. Repeatedly. Eventually we realized that at home she wasn't feeding herself properly or administering her own meds properly. So our family decided for her that she needed to move to a senior living place. That was a year or two ago and she is thriving there. If we had left her at home, living on her own, I don't think she would still be here.

Or, in other words: I hear you and that there are no easy answers. Getting old is hard. Getting old with strange medical beliefs is harder.

[adrian_turtle]

My mother is not going into any kind of senior living place. She cares too deeply about her privacy and independence* and not enough about her survival**.

*Her life would be easier and safer if we hired somebody to come in once or twice a week to help with cleaning the house. Or if she could have groceries delivered. Or if she could send out her laundry rather than carrying it downstairs and doing it herself. All these are intolerable. She doesn't want anyone coming into the house except maybe her sister or me, and she doesn't trust me to move or clean anything because she thinks I'll mess it up. (And besides, I live 700 miles away.)

**She has been at best kind of passively suicidal since my dad died.

[evalerie]

My mom was always fierce about not going anywhere. She always told my sister and me, "If you put me in a place I will die." And we always knew that she would *hate* being in any kind of group living situation. So I am always shocked that she loves it there. None of us ever expected that. The other incredibly surprising thing is that our relationship was very rocky until she moved in there, two years ago, at age 91 -- and then it turned really good. I think the fact that the senior living place turned out to be so much better than what she imagined made her trust my sister's judgement and my judgement, and that's what improved our relationship.

Anyway, your mom is not my mom, so things could well go very differently. But she does sound a lot like the "before" picture of my mom, before my mom moved to senior living. And that all went so very much better than I expected that I thought it was at least worth mentioning. But, as they say, your mileage may well vary!

[adrian_turtle]

It was an excellent suggestion! I'm glad it worked out so well for your family. I know it can relieve a lot of pressure in some situations, where people find a good group living situation. What makes this so hard is that my mom has not been able to make any friends and not wanted to let anyone into her home since 1987. She kind of put up with it when she thought my brother needed her, in the 1990s. (We're running into her strange social beliefs now, but her sister strongly recommended that she move to Columbus and join my aunt and uncle's vibrant friend group in the 1990s, and she said she couldn't because she would be a third wheel.)

[evalerie]

Yes, your mom sounds so very much like my mom! Which is why it's so unexpected that she loves her senior living place!