Life Isn't Always What It Seems

I spend my days writing about a wide range of healthcare topics for my clients, but I had never been assigned a project about concussions or PTSD. Yet for the last few months, I’ve been digging into these topics like never before — and this time it’s personal. 

The Crash
I was emptying the vacuum cleaner a few minutes after my 17-year-old daughter left for a babysitting job. As soon as the phone rang, I just knew and said a silent prayer, “Please let my girl be okay.”

As the call connected, I could hear her sobbing, “Someone hit me. Someone hit my car.”

With my heart pounding and my body shaking, I headed to the accident site and arrived before the police and EMTs. I parked on the side of the road and immediately dashed Frogger-style to her crunched car which was straddling the center turn lane and a slow-moving line of traffic.

Although she was shaken up, she appeared to be physically okay. My mom heart relaxed a little bit as I hugged her. The airbag hadn’t gone off, but the blow was hard enough to send her glasses flying into the back seat. While I comforted her, several kind souls offered assistance and retrieved her glasses.

20 Questions
By this time, the first police officer had arrived and began asking the same questions she’d answer a million times more. (I’m not complaining, I appreciate the thoroughness of first responders, hospital staff, doctors, insurance company, etc.)
• Did the airbag go off? No.
• Did you hit your head? I don’t think so.
• Did you lose consciousness? I don’t think so.
• Were you wearing your seatbelt? Yes.
• Does anything hurt? My neck and shoulder hurt a little, and my hands burn from the friction of gripping the steering wheel so hard.

To be safe, B wanted to get checked out at the hospital, sooner rather than later. Since she didn’t seem to have any serious injuries, she said she’d go in the ambulance by herself while I finished talking to the police.

“I’m almost 18 and I’ll have to do things like this by myself eventually,” she said as the thumping in my chest continued. Her dad met her at the hospital while I finished the police report, retrieved her belongings from the car and waited for the tow truck. My heart hurt as the ambulance pulled away.

Fast Forward
More than three months later and our daughter is still recovering from the accident.

After being checked out at the Emergency Department, she was told to anticipate more pain the second day (which happened), to rest and to take a few days off work. 

It was mid-summer and she seemingly returned to her normal life – working, hanging out with friends and looking forward to her senior year. She struggled at work with severe neck and shoulder pain, as well as dizziness and fatigue, but tried to shake it off. She saw her PCP, underwent an x-ray and started physical therapy.

As her pain subsided, we expected the dizziness, nausea and fatigue would resolve itself. But it didn’t. She could barely work for an hour before her supervisors would notice she didn’t “look right” and would send her home. When out with friends, B would cut her socializing short and ask me to pick her up – she was too lightheaded and sick to drive.

Something wasn’t right.

Hello, Concussion
Her medical team determined that she had an undiagnosed concussion, vestibular hypofunction and PTSD. On a Dizziness Handicap Inventory B completed with her physical therapist, she scored 84 out of 100 – meaning that her symptoms interfere in all aspects of her life to an extremely high degree.

Although she didn’t think she hit her head or lost consciousness during the accident, she now realizes there’s a gap in her memory of the accident. She remembers seeing the car coming at her and then she doesn’t remember anything else until someone came up the window to see if she was okay. 

In retrospect, we underestimated the impact this relatively minor car accident had on B. Diagnosing a concussion is harder to identify than a broken bone or a bleeding wound. Although a concussion is considered to be the mildest type of Traumatic Brain Injury (TBI), it is a brain injury nonetheless.

Back to School
When school started seven weeks after the accident, B headed to school ready for her senior year, but quickly realized her dizziness and nausea were more than she could handle. She kept trying to stay in class, but she spent the bulk of her days in the nurse’s office or retching in the bathroom.

We then worked with the school to develop a 504 (a plan that accommodates a student’s disability so they can continue with their education). We barely started that plan when we realized even those accommodations weren’t enough for her condition.

B’s therapist recommended that she request Home/Hospital tutoring through the school district. Her primary care provider and neurologist heartily agreed. This was devastating news for her, but from a medical standpoint it highlighted the significant effect a concussion can have, especially if not diagnosed and treated immediately.

Obvious vs Not-So-Obvious
When an athlete takes a hard hit and is diagnosed with a concussion, they follow a concussion protocol that dictates when they can return to the field or court. As an avid NBA fan, I’ve been well aware of this return-to-play requirement.

In my effort to support my daughter’s recovery, I came across an article that really resonated with me, particularly when the writer referenced a return-to-learn protocol. It clearly addresses some of the exact physical challenges B has encountered. And this doesn’t even include the PTSD she’s been diagnosed with.

While this information is helpful from an intellectual standpoint, there’s still a social component that is hard to define and difficult to address. If B was sporting a cast or hobbling around on crutches, people would recognize her injuries. Yet, to many people, she’s just being weak, lazy or imagining her symptoms.

But these people don’t see her crying at home because she’s missing out on her last Homecoming week or watch her lose her balance suddenly or notice the exhaustion in her eyes when she’s spent too much time trying to read her text books.

They don’t see her worrying that her employer will be mad she’s been on leave so long or hear about her most recent nightmare (a school shooting, another car accident, etc.) that kept her up at night when she really needs her sleep to properly heal. They don’t see her total exhaustion after one hour with the tutor.

A New Perspective
In addition to our family, we are blessed with fantastic healthcare providers, supportive school administrators, compassionate teachers and a few loyal friends. We are so thankful for those people who are helping B get through this challenging time in her life. But we are also disheartened that so many people don’t “get” invisible medical conditions.

It’s my hope that sharing our story will help in two ways. First, I hope that those who “just don’t feel right” will pursue a diagnosis and treatment plan that helps them heal. Second, I hope that healthy people or those who bounced back quickly from an injury won’t judge others, call them weak or be snarky about symptoms they think are fake.

As Brad Meltzer reminds us, “Everyone you meet is fighting a battle you know nothing about. Be kind. Always.”