The silent epidemic of concussions and head injuries

A bump on the head transformed Alana Hurov from a successful television producer into a gummi-bear-eating recluse. Then a near-death experience helped her find the strength to start over

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Concussion woman lying on couch
Masterfile

It was a Thursday night in March 2009, and, as usual, I was running late. With one foot out the door, I noticed the blinds in my living room were open. As a Type A neurotic and superstitious over-thinker (open blinds are bad feng shui), I had no choice but to go back and close them. But as I was pulling them shut, the entire five-foot-long plastic valance crashed down onto my face. I stumbled toward the mirror to find blood dripping from a gash between my eyes. I’d also broken my nose.

A friend took me to the hospital, where I went into sensory overload. The fluorescent lights seemed blindingly bright, and the sound of paramedics pushing gurneys down the hall pierced my ears. My freak accident resulted in a diagnosis of “mild concussion.” It’s what happens when a blow to the head shakes your brain back and forth against the inside of your skull, causing a brain injury. Thousands of Canadians suffer from them every year and up to 80 percent deal with ongoing symptoms, which can include headaches and problems with concentration, memory, judgment, balance and coordination. But most people recover quite quickly, and I was told to rest for a few days, and all would return to normal.

Unfortunately, for me the days quickly turned into months. I was in and out of the emergency room with debilitating migraines, nightly insomnia and fatigue. My calendar was jam-packed with appointments with neurologists, psychologists, psychiatrists, support groups and, eventually, rehab. From CAT scans to MRIs, all of the tests came back normal. Although every doctor I saw diagnosed me with a concussion, no medical test could prove it. It’s like breaking your leg, but all of the X-rays come back normal, even though you can’t walk. This is a common and frustrating fact of life for most brain-injury patients, says Toronto neurosurgeon Dr. Michael Cusimano. “Most routine tests like MRIs can’t identify microscopic fibre or blood vessel tears in the brain caused by blows to the head,” he says. “Properly diagnosing and treating a concussion boils down to listening to a patient’s symptoms over the long term.”

Because no two brains are alike, those symptoms often vary. “A person’s genetic makeup accounts for some of how the injury will manifest,” Cusimano says. “It’s no different than someone who smokes their entire life and has a clean bill of health, while others who maintain a healthy lifestyle get terminal cancer. Some people are just more susceptible to certain injuries and illnesses.” One example is actor Natasha Richardson, who died from a brain injury after a minor fall on a beginner ski slope at Mont Tremblant in 2009. In her case, an epidural hematoma caused bleeding under her skull that put pressure on her brain. She complained of a headache and was dead two days later. It’s a sharp contrast to NHL star Sidney Crosby, who has suffered multiple concussions but is back on the ice.

From bump to breakdown
After my own blow to the head, nothing was the same. I went from being a successful television producer and yoga teacher to a recluse hidden away in my 550-square-foot condo. I gained 15 pounds, and when I left the safety of my home for more than an hour, I suffered debilitating panic attacks. If I walked for more than 10 minutes at a time, I was bedridden for a week. The more I did, the worse I felt and the longer it took to recover.

Doctors told me to simply stay at home and do nothing. “The best way to treat a concussion is generally through rest, counselling and a very gentle return to normal daily activities,” Cusimano says. It was boring and depressing, but I had no other choice. Bright colours in the grocery store overwhelmed me. Passing cars made me dizzy. Sounds of a busy restaurant were unbearable. Every sense was heightened. For about five months, a good day was bathing and having enough energy to change out of my yoga pants. Most of my ‘meals’ consisted largely of gummi bears and bananas. I couldn’t face the thought of shopping, cooking or doing much of anything. But it was only when I started thinking about taking my own life that I went to my family doctor for help. He prescribed antidepressants, but I didn’t fill the script because I didn’t want to become dependent on medication.

I also couldn’t believe a simple bump on the head could have caused my mental and physical fallout. But I’ve since learned that around 30 percent of concussion patients suffer from depression. “Think of the brain like a snow globe,” says Toronto psychiatrist Dr. Shree Bhalereo, who specializes in traumatic brain injuries. “When you shake a brain, everything doesn’t settle the same way. Serotonin levels are disrupted, which pushes the nervous system out of balance.” Even months or years later, concussion patients can suffer from a myriad of problems: hypersensitivity to light and sound, fatigue, personality changes, lack of motivation, lack of sex drive, sleep issues and memory loss. “Many patients lock themselves inside and simply say ‘Forget it,'” Bhalereo says. “They feel like a different person and focus on their past, fully functioning life. It sets the groundwork for depression and even suicide.”

In fact, two NFL stars recently killed themselves after lengthy battles with depression as a result of chronic traumatic encephalopathy, a degenerative disease caused by repetitive concussions. Researchers are now investigating whether brain injuries may be partly to blame for a rise in suicides among American war veterans returning from Iraq and Afghanistan. The U.S. government is researching whether shock waves from bombs are causing concussions similar to the life-altering blows to the head people sustain in professional sports.

Reaching rock bottom
A near-death experience made me realize I was on a dangerous path. A friend from Montreal came to stay with me for a few days. She was expecting a fun girls’ weekend filled with shopping, dancing and great food; instead she was dragged into my pit of misery. I forced her to stay inside and watch depressing movies, while I licked Nutella right from the jar. One day she came in to find me curled on the floor, sobbing. On the morning she was to leave, I insisted on driving her to the airport. I needed to prove that I was still capable of living a normal life — and I almost killed us both. Already driving too quickly, I was suddenly distracted by a blond woman on the sidewalk. I found myself wondering where she was off to in such a rush, and it wasn’t until I heard my friend scream that I realized we were headed into oncoming traffic. I swerved and just managed to regain control of the car in time. The next day, I took a cab to my doctor’s office. He revoked my license for a year, and I filled my prescription for the antidepressant Wellbutrin. Within a month I started to feel healthy and whole again. I was sleeping normally, making better food choices and feeling hope for the first time in months.

Finally, I found the strength to slide back into my runners. I went for a walk outside, carefully putting one foot in front of the other. I was happy for the first time since the accident — and I was so grateful to get another chance at life. I started doing yoga again and, after an eight-month absence, finally returned to work with mixed emotions. I didn’t know how the new Alana would adjust to a high-stress TV job. In my 15 years of broadcasting I thrived on stress, deadlines and breaking news. The brain-injured version of me was still struggling with anxiety, tension headaches, light sensitivity and vertigo.

Although my workplace had been extremely accommodating and helped me readjust to my daily duties, the biggest challenge was that I looked the same but felt completely different. At times, I was ashamed to admit I could no longer perform at the same level. I was constantly feeling stressed — walking through the newsroom caused me severe anxiety to the point where I’d freeze up and couldn’t work.

Brain injuries like concussions are often called “the silent epidemic,” says Dr. Kevin Gordon, a pediatric neurologist at Dalhousie University in Halifax. “In the ’50s we put bandages on people’s heads, but we don’t do that anymore. So people with brain injuries struggle, because they look normal but feel terrible. Nobody knows that they aren’t well. It’s like when you drop your computer. You don’t notice the glitches in software until you try using it.” Fortunately, my employer was understanding and moved me into long-term network-planning positions with minimal stress. But I continued to struggle with headaches, lack of concentration and the hectic work environment. After about a year of feeling like a square peg in a round hole, I knew I had to make a change.

Rebuilding a life
In 2011, I left the relative security of my media career to create my own health and fitness company. I try to eat healthy (no more gummi bears) and practise yoga daily. I still struggle with symptoms: difficulty hearing in noisy environments, vertigo, memory loss, forgetting names and faces, and anxiety. The symptoms may dissipate over time or last forever. There’s no real treatment other than staying positive and present in the moment, but I now understand that health is a gift that can be taken away at any time. The universe forced me to sit down for nearly a year; now it’s time for me to get moving again. My new venture has been successful and I now have 100 staff members on my team. It took a lot of courage and endless hours of work to get here, but I am so relieved that I eventually followed my heart after I hit my head and didn’t let my brain injury get the better of me.

Read on for signs you have a concussion.