Pod Insights All In The Mind The confusion about concussions About this episode Concussions are hard to diagnose, often get missed, and don't always get taken seriously.
And if you're not a professional athlete, it can be surprisingly hard to get clear information on how to manage and recover afterwards. Why?
The brain is your most important organ, after all!
This week, we try and make sense of the confusion around concussions.
This episode was first broadcast in October 2023.
Guests:Dr Lewis FreethPsychiatrist
Kate
Naznin Virji-BabulPhysical therapist and neuroscientistAssociate Professor, Department of Physical Therapy Faculty of MedicineUniversity of British Columbia
Shreya McleodPhysiotherapistLecturer, Australian Catholic UniversityPhD candidate, University of Newcastle
Credits:
Presenter/producer: Sana QadarProducer: Rose KerrSound engineer: Russell Stapleton
Transcript 0:00 Speaker 00 ABC Listen, podcasts, radio, news, music and more.
0:07 Speaker 01 Hey there. A heads up, this episode is one from our archives.
0:12 Speaker 02 The way to think about your brain is that it's very vulnerable. And if you had to pick an organ, some guys would say it's the second most part. If you had to pick an organ which is most important to you.
0:26 Speaker 01 Right.
0:26 Speaker 02 I think, I mean, it's who you are.
0:28 Speaker 01 Yeah.
0:29 Speaker 02 And so if that's damaged.
0:31 Speaker 01 Yep.
0:31 Speaker 02 Then your whole experience of life is altered.
0:37 Speaker 02 So I was in third year, Newcastle Uni, halfway through medical school.
0:42 Speaker 01 This is Lewis.
0:43 Speaker 02 And I'd just done four weeks placement in a place called St Lucia in South Africa.
0:48 Speaker 01 And this is Kate.
0:49 Speaker 03 It was a beautiful sunny Friday afternoon, just finished work for the week.
0:54 Speaker 01 And on these particular days, several years apart and on separate continents, they were both in great moods. They were happy and excited for what lay ahead.
1:04 Speaker 02 It was the first day of backpacking around South Africa and Zambia after I'd finished my placement.
1:09 Speaker 03 And it was 35 degrees. I had a long weekend coming up. It was just like, I was just so ready to go home and start my long weekend.
1:17 Speaker 02 And I got the hire car, the cheapest one I could as a uni student. I drove five hours to the really cool place to go hiking and.
1:26 Speaker 03 I was riding my bike. I was probably going about 15 kilometres per hour trying to cross an intersection that was part of suburbia.
1:32 Speaker 02 I was driving to the hostel, a beautiful hostel in the middle of the main valley. And as I was coming up to the turnoff, there was a car behind me, probably the only one I'd seen for about an hour, going really fast behind me.
1:44 Speaker 03 There was no cars around and I hit the curb and a lot of things happened at once. My front wheel somehow has become dislodged, so I faceplant straight into the footpath. I am on my back screaming like I've never screamed before.
2:04 Speaker 02 There was a car behind me going really fast, so I put on my right blinker. I didn't want him to come up the back end of my car. And that's the last thing I remember.
2:19 Speaker 01 This is All in the Mind, I'm Sana Qadar. Lewis was knocked unconscious in the crash. Kate was awake, but she was pretty banged up. She'd broken some bones and had a black eye. Both had concussions.
2:32 Speaker 02 The next thing I remember is waking up in the middle of a paddock with about 20 people around the car.
2:40 Speaker 01 Now, usually when we hear about concussions, it's in the context of professional sport. Much less attention and research is paid to concussions that happen in everyday life. That means, for the average person, it can be surprisingly hard to get clear information on what to do next.
2:57 Speaker 03 I had my head scanned and I was discharged that night and given a pamphlet about concussion. We'll see you in six weeks, essentially. I felt not equipped at all.
3:08 Speaker 02 I saw one neurosurgical registrar and I said, "What should I do?" He said, "Oh, I think, don't use your brain." And then another one I saw said, "Use your brain as much as you can, try to get it going." And in my head, I was like, "Which one am I doing?"
3:24 Speaker 01 Add to that the unpredictable nature of concussions.
3:27 Speaker 04 You take two people and hit them over the head with the exact same amount of force and in the same place, and they would probably experience that blow very differently.
3:37 Speaker 02 And there's not an exact correlation between how hard you hit your head and the impact that it has on your brain.
3:43 Speaker 03 Concussion is so underplayed and poorly understood that I felt like I wasn't prepared and I felt like everyone around me wasn't prepared because it's not taken as seriously as it should be.
3:54 Speaker 01 So today, we wade through the confusion around concussions, why they often fall through the cracks of medical care, and what the research says you should now do if you hit your head.
4:10 Speaker 03 It looks like I'm getting the thumbs up for my...
4:12 Speaker 01 Have you ever thought about what happens in the brain during a concussion? Like, the mechanics of it? Nazanin, can you hear me? It's pretty graphic, actually.
4:20 Speaker 04 Yeah, I can hear you.
4:21 Speaker 01 Here to describe it is Nazanin Verji Babbel.
4:23 Speaker 04 I'm a physical therapist, a neuroscientist, and associate professor in the Department of Physical Therapy at the University of British Columbia in Vancouver. So when there's a blow to the head or any part of the upper body, the brain actually slams into the inside of the skull, on the front part of the skull, and then the brain kind of... Vibrates backwards. So both the front part of the brain and the back part of the brain are actually slamming against the skull. On top of that, there's actually a rotational component. So you get some shearing, micro shearing, that's within the wiring of the brain. That's essentially what happens when somebody is hit on the head or body.
5:08 Speaker 04 But, you know, it's not really necessary to have a physical blow. What we're now starting to understand from studying the soldiers on the field is that blast injuries result in the same type of brain injury. The blast actually causes the brain to vibrate inside the skull.
5:27 Speaker 01 Wow.
5:28 Speaker 04 And it is similar type of damage.
5:30 Speaker 01 So even if the body hasn't been, I mean, in those situations with the body have been moved and blasted backwards as well?
5:37 Speaker 04 Sometimes the body has moved, but other times, you know, they're quite far away from the blast and it's just the impact of the vibration on the brain inside the skull that causes that.
5:47 Speaker 01 That's incredible. So you could be standing still and your brain still gets a concussion?
5:51 Speaker 04 That's right.
5:52 Speaker 01 Wow. And when you say shearing, is that like tearing of the wiring in the brain?
5:57 Speaker 04 Yes, micro tearing is what we call it. So your brain is made up of grey matter and white matter. The white matter are actually, it's what we call the wiring that actually connects the neurons to each other. And that wiring starts to get sheared.
6:15 Speaker 05 It creates a huge neuro metabolic cascade, which means that there's quite a lot of changes within the ions in the brain itself. And this creates an energy crisis, so to speak. So there's a huge amount of energy required to deal with this injury. And that creates changes to brain function.
6:38 Speaker 01 That's why you end up with symptoms like headaches, dizziness, trouble concentrating and processing new information, trouble seeing, nausea. But it's only usually for a short period of time. This is Straya MacLeod. She's a physiotherapist and lecturer at the Australian Catholic University. And she's currently doing her PhD in sport-related concussion. And like she says, luckily, most people who get a concussion will recover on their own, within about four-ish weeks. But, and there's always a but, there is a sizable portion, around 15 to 30% of people, who take much longer, months or sometimes even years. And they can be left with ongoing brain fog, trouble sleeping, mood changes like anxiety,
7:22 Speaker 01 even personality changes.
7:24 Speaker 04 I had this one woman who came to our lab who had fallen off a ladder. She said she used to be a very kind of type A personality, you know, very intense, very organised. And after the concussion, she was just so laid back. She feels like she's a completely different person.
7:42 Speaker 01 Is that the kind of change that would be permanent? Or would that sort of go away after a while?
7:47 Speaker 04 With her, it went away. But it took almost six months before it went away.
7:51 Speaker 01 Wow.
7:55 Speaker 01 How much force is required to result in a concussion? Like, what tips a head knock over into concussion territory? Do we know?
8:03 Speaker 04 You know, there's been a lot of studies on this. And there doesn't seem to be a direct correlation with the amount of force or even where the person has been hit on the head or the body. It's so complex how the brain responds to that. I think part of it is, you know, first of all, whether someone's had a brain injury before. We know that there are certain kinds of genes that seem to be more linked to how quickly you recover from something. There are so many, many factors. So you take two people and hit them over the head with the exact same amount of force and in the same place. And they would probably experience that blow very differently.
8:44 Speaker 01 Or you take the same person and give them two separate knocks, and the experience can also be very different. That was the case for Lewis Freeth. So initially, he was lucky. No one died in that car crash he was in, and his brain injury was mild, despite what was a pretty dramatic crash.
9:02 Speaker 02 One lady saw it at the hostel from a distance, and what probably happened was that I turned right to go into the hostel. And don't ask me why this rule exists, but there was some unwritten rule in that specific rural area of South Africa that if you put on your right blinker, then it means I'm slowing down, overtake me.
9:22 Speaker 01 Oh.
9:23 Speaker 02 So I went to turn right, and he thought, overtake. So he hit me right on the driver's side.
9:30 Speaker 01 Oh, wow. Okay.
9:31 Speaker 02 And so I would have lost consciousness, and my foot probably went on the accelerator.
9:36 Speaker 01 Oh, my gosh.
9:37 Speaker 02 And then I went into a ditch on the side of the road, and the car flew over the paddock fence. And I went another probably 50 metres into the paddock. But when I got out of the car, didn't have a scratch on me.
9:48 Speaker 01 Wow.
9:49 Speaker 02 Felt okay. Obviously, a little groggy, but... And then got into the ambulance, went to the hospital, like, pretty remote hospital.
9:56 Speaker 01 Hmm.
9:56 Speaker 02 And I was fine. And I've thought about it since it happened. And I wasn't really using my brain in a very taxing way, backpacking around. So I probably didn't test to see how it was feeling.
10:09 Speaker 01 Right. And the weeks and months following, no sort of effects afterwards?
10:13 Speaker 02 I think if I had have been working or studying, then I would have noticed them. But I was able to do everything I wanted to do. I was also 22 or 23.
10:22 Speaker 01 Hmm.
10:22 Speaker 02 So I probably, yeah, sort of had a bit more of a carefree month there.
10:29 Speaker 01 But nine months later, back home in Newcastle, Lewis's carefree luck would run out.
10:35 Speaker 02 So, growing up, I played a lot of rugby. And I was playing for the University of Newcastle all through the first few years of uni up there. And this one is actually on video. I can show you after the recording.
10:49 Speaker 01 Oh, yeah.
10:50 Speaker 02 And it's probably one of the more spectacular head knocks you'll see.
10:54 Speaker 01 Can you actually show me while we're recording?
10:57 Speaker 02 Yeah, I can show you right now.
10:58 Speaker 01 Yeah.
10:58 Speaker 02 Yeah, yeah.
10:59 Speaker 01 If you're happy to share, if that's not too hard to watch.
11:02 Speaker 02 No, no, I've watched it a lot of times.
11:05 Speaker 01 Gosh, okay.
11:06 Speaker 02 One of my friends made a meme about it, actually.
11:09 Speaker 01 Okay, you well and truly processed then. Before Lewis gets to the video, he shows me a photo of what he looked like after the hit.
11:17 Speaker 02 So this is the aftermath.
11:18 Speaker 01 Oh my gosh, wow, that's a very black eye. Okay.
11:20 Speaker 02 Yes.
11:21 Speaker 01 In the photo, he's sitting up on what looks like the hospital bed. His right eyelid is shut and it looks like someone's painted a big splotch of purply black eye shadow all across it.
11:33 Speaker 02 This is the video here.
11:34 Speaker 01 Okay.
11:34 Speaker 02 So I'm at the back.
11:36 Speaker 01 Mm hmm.
11:36 Speaker 02 I don't know if you're a rugby.
11:37 Speaker 01 No, I know nothing about rugby at all.
11:40 Speaker 02 I'm playing a position called fullback.
11:42 Speaker 01 Okay.
11:42 Speaker 02 I'm in the red and white. The Maitland player is in black.
11:45 Speaker 01 Okay.
11:46 Speaker 02 He kind of steps inside and my own player, who was coming from behind to tackle him, didn't adjust and just more or less head butted me.
11:55 Speaker 01 Okay.
11:57 Speaker 01 So this first time that Lewis plays the video, it's only four seconds long and I see a bunch of people go down, but I missed the actual hit.
12:05 Speaker 02 Did you see that?
12:06 Speaker 01 No, hang on, that was hard to catch.
12:07 Speaker 02 Yeah, yeah, yeah. Sorry, I'll point it out.
12:09 Speaker 01 Where are you?
12:09 Speaker 02 So that's me at the back there.
12:10 Speaker 01 Okay, yep. This time I've got my eye on him and I see when the two heads make contact. And Lewis's head and neck jerk backwards at an angle really violently and he falls to the ground. Oh my god.
12:25 Speaker 02 That's the reaction. Yeah, so I was probably.
12:27 Speaker 01 That's a direct hit right to the head. You're straight down.
12:30 Speaker 02 Yeah, so I was probably a hundred kilos there and just via impact to my head, my feet left the ground.
12:38 Speaker 01 Yeah.
12:40 Speaker 02 And what's really interesting.
12:41 Speaker 01 And he was fine? Like, because his head's smashing into yours.
12:45 Speaker 02 So he, he got a concussion.
12:47 Speaker 01 Okay.
12:47 Speaker 02 Um, but if you look closely at the video, I was a bit more upright.
12:51 Speaker 01 Okay.
12:52 Speaker 02 And he was kind of bending down, ready for the tackle.
12:55 Speaker 01 Right.
12:56 Speaker 02 And so in terms of the actual impact on the brain, there wasn't really much.
13:01 Speaker 01 Right, okay.
13:01 Speaker 02 Um, whereas I copped a bit more of that one.
13:06 Speaker 01 Do you remember that moment? Do you remember him coming at you? Did you have any...
13:09 Speaker 02 Yeah, so what's really interesting and one of the things that intrigued me with TBI was I actually didn't lose consciousness with that one.
13:16 Speaker 01 TBI stands for traumatic brain injury, which is what a concussion is.
13:20 Speaker 02 And I remember everything. And in terms of the effects in the weeks to month or two after, that was much worse. But yet I didn't lose consciousness. So it showed me the maybe complexity of the issue and how just putting it down to a simple, you know, did you lose consciousness or not paints nowhere near the whole picture, yeah.
13:48 Speaker 01 After his hit, Lewis was immediately taken off the field.
13:52 Speaker 02 Part of me was thinking about going back on the field, which few great physios we had there convinced me not to.
13:58 Speaker 01 Next, he was taken to hospital where doctors found he'd fractured his skull and was at risk of infection. He was given antibiotics and the next day he was discharged. And so, once you were discharged from hospital, what information were you given about the concussion and like what to look out for and what to do to heal?
14:16 Speaker 02 It was a while ago now, but there definitely wasn't anything substantial told to me in terms of follow-up with anyone dealing with concussions or what to do for your brain health. There was, I would say, probably nothing. If there was something, I don't remember it.
14:36 Speaker 01 This was several years ago, it was back in 2017, so you'd hope things have changed a bit since then. But when Kate got her concussion this year, after falling off her bike, she also felt she didn't get enough information on what to do, apart from a pamphlet.
14:52 Speaker 03 The pamphlet was kind of like a cheat sheet and it was told to reduce screens for the next 48 hours, to have someone with me.
14:59 Speaker 01 So you left hospital, you had this pamphlet. How did you feel about how equipped you were to monitor and deal with your concussion?
15:07 Speaker 03 Not equipped at all. I felt so out of my depth. There's this piece of paper telling me what to do. I'm the one who's concussed, I can't process information at the time.
15:17 Speaker 01 Over the following weeks, Kate found herself feeling more anxious and unable to concentrate.
15:22 Speaker 03 All of a sudden, it was just falling apart. I felt like I couldn't go to work, remembering to do simple things like check emails and actually reply to them, which is something I experienced with my ADHD anyway. But that problem would persist more than normal. So all the things that I normally struggle with my ADHD, they suddenly became 10 times worse.
15:41 Speaker 01 A side note, having ADHD puts you at greater risk of getting a concussion and can make recovery harder.
15:47 Speaker 05 Because the brain is already working harder to respond to the environment. So having an additional load, which is created by a concussion, just increases the cognitive load.
16:00 Speaker 01 Physiotherapist Shreya MacLeod says gender also plays a role.
16:04 Speaker 05 Females are more susceptible to head injuries than males. They tend to take longer to recover as well than males.
16:12 Speaker 01 That partly has to do with the fact that women have smaller necks.
16:16 Speaker 05 So when women take a hit, we can potentially get a stronger or higher whiplash, which then creates a change in the response to how we deal with concussion.
16:28 Speaker 01 But Kate had been told none of this.
16:32 Speaker 03 And then I think what happened is, as my shoulder became broken, that was the more visible injury. So I would have friends, family, acquaintances come up to me and say, "Hey Kate, how's your shoulder going?" Instead of, "How's your brain going?" So I think this is the insidious nature of concussion and mental health in general, is that it's not visible.
16:57 Speaker 01 There are a number of factors that collide in a way that mean concussions don't often get the attention they need. Visibility is one, but there are a few others. First, if you're not a professional athlete, you're already at a disadvantage.
17:10 Speaker 05 People who are playing high-level sports have several health practitioners available to them. Athletes are dealt with in a sequential manner, in the sense that they are managed with what's called a head injury assessment process. It is very different in the community because there are no Trainspotters, so to speak, and people playing sport in the community or people in the community don't have access to a concussion management team.
17:37 Speaker 01 This is the camp Lewis fell into. Even though he was playing rugby when he got his second concussion, it was at a university level. So while he initially had a team physiotherapist that got him off the field, in the weeks and months following, he was left to navigate his symptoms alone. And even though he was a medical student at the time, even he was confused, especially after one neurosurgeon said to him,
18:00 Speaker 02 Don't use your brain.
18:01 Speaker 01 And the other said,
18:02 Speaker 02 Use your brain as much as you can, try to get it going. In my head, I was like, what, which one am I bloody doing?
18:07 Speaker 01 So unless you're in high level sports, there's no one to help you manage and navigate what to do afterwards. But why is that? Well, point two, concussions aren't the domain of any one medical specialty. Lewis knows this especially well because after medical school, he started training in neurosurgery before switching to psychiatry.
18:27 Speaker 02 TBI doesn't fit neatly into a specialisation. So it's basically a structural problem with largely psychiatric symptoms.
18:36 Speaker 01 Hmm.
18:37 Speaker 02 So working in neurosurgery, the question is, operate, yes or no? No? Okay, move on. Working in psychiatry, the structure of the brains I've never seen considered.
18:48 Speaker 01 Hmm.
18:48 Speaker 02 And I think that's why TBI slipped through the cracks. And I think that that's a product of just the over-specialisation when we're thinking especially about the brain. Within medicine, when you're dealing with the brain, you've got neurosurgery, neurology and psychiatry. And I think to make our jobs as doctors easier, we like to pretend they're three largely separate fields. And I think the lines between them are so much more blurred.
19:12 Speaker 01 A third factor that means concussions are often overlooked is simply that they're hard to diagnose.
19:19 Speaker 04 We don't actually have a good, objective way to diagnose concussion.
19:23 Speaker 02 No blood tests, there's no scans. The neuropsychological tests take a long time. They're pretty onerous.
19:29 Speaker 04 It's usually done through a physician doing various assessments just to look at very generally balance, memory, symptoms. But it is, it's not a very reliable way of diagnosing. But right now, that's all we have.
19:44 Speaker 01 And the final factor I'll mention here is the research on concussions has evolved rapidly. So not all clinicians are always up to date. Here's neuroscientist Dr Nazanin Verji Babal again.
19:56 Speaker 04 For the longest time, when somebody had a concussion, the advice from the medical community was that you basically rest and rest in a dark room and don't go anywhere and don't do any, you know, screen time, don't talk to people and just rest. I've had people come in my lab who have been resting in a dark room for several weeks and are just getting worse. And we now know from a lot of studies that prolonged rest is actually the worst thing. It actually delays your recovery, but it's also associated with greater mental health issues because you have someone who's usually, especially if it's the athletes, they're usually very social and now suddenly they're deprived of any stimulation.
20:38 Speaker 04 I think anyone would probably start to feel some anxiety, some depression. So I think now, you know, all of us who work on concussion are trying really hard to get the word out to medical community, the health professionals, but also to people that the most that we're recommending is that you rest maybe for 24 to 48 hours. But after that, you really have to start getting up, exercising, whether it's through a stationary bike or going for a walk.
21:07 Speaker 05 We certainly want graded exposure.
21:09 Speaker 01 Physiotherapist Ray McLeod agrees. Slowly going back to your normal daily activities after a period of 24 to 48 hours is the way to go.
21:17 Speaker 05 So every 24 hours, we build on the amount of exposure to your normal activities. So every 24 hours, you progress through a different stage. If you find that your symptoms are exacerbated, we want you to drop back to the previous stage.
21:31 Speaker 01 And is that because you need to challenge the brain as it's getting better? So you're actually recovering fully? Is that why rest fully isn't recommended anymore?
21:39 Speaker 05 Correct. We want to provide the brain with the ability to gauge whether it's ready to move on to those activities. If you rest completely for longer than 48 hours, it actually is detrimental towards your outcomes.
21:55 Speaker 04 We used to think that concussion was just a simple ding to the head, you know, something not to be taken very seriously and that you would recover right away. And a lot of times we would hear this from, I would hear this from the participants who were coming into my lab that, you know, they got hit in the head, they felt dizzy, they wanted to step off the field. And people would just say, you know, be a man, just get in there and play. That was, you know, literally only 10 years ago where that attitude was that it's not being serious and you should just keep playing. Now we know, and you know, 10 years is a fairly short time span in the field of research.
22:35 Speaker 04 But within the 10 years, what we now really have a good understanding of is that concussion really is a traumatic brain injury. There's no question about that. And there are widespread changes because of the kind of damage that occurs in the brain. And one thing that I was quite surprised about when I started my research was the changes in emotion regulation. A lot of would come to the lab and say, you know, my kid had this blow to the head and now it's this is not my child, you know? They're always upset, always crying, little things. Like they've completely changed their personality in terms of how we see them responding to just normal things that are happening in their environment.
23:21 Speaker 01 Emotional dysregulation was the hardest symptom Louis Freeth struggled with after his second concussion. He also had trouble concentrating and processing new information, but the emotional stuff really threw him.
23:34 Speaker 02 There's one instance I remember really clearly where I stubbed my toe on the, I don't know, a coffee table or a chair or something. And instead of, oh, Louis, you've stubbed your toe, that sucks. Like ordinarily, you'd be able to put that into some sort of context. It's just gonna be painful for a few minutes, it's not the end of the world. Like you can kind of talk to yourself like that. But I remember there was no processing there. So it was just like, instead of Louis feels pain, it was just like pain, only pain.
24:05 Speaker 01 When we spoke on the phone, you described it in a really incredible way. You said how you stubbed your toe and your emotional response was like, as if the world was ending.
24:16 Speaker 02 It was, I don't know how else to explain it, but that's, that's what it felt like.
24:23 Speaker 01 Do we know why that happens?
24:25 Speaker 04 Well, you know, one area of the brain that seems to be very vulnerable to this kinds of blows to the head is an area called the prefrontal cortex. And that area controls a lot of our emotions. It controls how we make sense of the stimuli that we're getting and how we respond to that, and how we express and understand and perceive our emotions. So it's not surprising that we see that, especially with people who've had multiple concussions.
24:57 Speaker 01 Thankfully, both Lewis and Kate eventually recovered from their concussions after about three to four months, but it wasn't easy.
25:04 Speaker 03 I definitely had to advocate for myself with my concussion. It's something that I had to seek out myself. And I would have kept wondering, there's got to be something else going on here. It's not just my ADHD. It's not just my ADHD medications.
25:18 Speaker 01 Kate ended up taking a few months off work to recover, but Lewis was mostly able to stay in medical school. The biggest change is he no longer plays rugby. Do you miss it?
25:28 Speaker 02 Yes. It's the camaraderie and the physical challenge and the mental challenge of rugby. I wouldn't change the fact that I played rugby at all. And I got a lot more out of it than damage.
25:41 Speaker 01 Now he's researching new and better ways of diagnosing concussions.
25:45 Speaker 02 We still don't know enough. Like, it's not something that, you know, anyone can say based on data and science. X amount of concussions, this happens. And most TBI patients do recover. But I think the issue is they go through something which is very unfamiliar and can be very confusing, and none of it's visible. It's the same with psychiatric illnesses, but depression much more talked about, anxiety probably more common as well. So people are more familiar with it. And it can present very similarly to something like that. And so a lot of people can be put on psychiatric medications with side effects when that's
26:30 Speaker 02 not the issue. And later in life, with multiple concussions, that's where a lot of issues can happen. Like, there's links to Alzheimer's disease and dementia of different kinds, just generally your brain not functioning as well.
26:44 Speaker 01 I think people also think of, like, CTE.
26:46 Speaker 02 Yeah, yeah, exactly. And that's, that's really only a new phenomenon as well, but we don't know what's going on to a hundred percent accuracy.
26:56 Speaker 01 And so based on what we know now, I want to leave people with a practical takeaway. What's your key message for what someone should do if they hit their head?
27:04 Speaker 02 I think if, if it's a severe hit, or if you experience any major changes physically, vomiting, double vision or nausea, not just vomiting, major headache, anything like that, probably go to ED.
27:18 Speaker 01 Mm hmm.
27:18 Speaker 02 You're always better off being safe than sorry. If there are any emotional cognitive changes, go see your GP. I think probably go see your GP either way.
27:28 Speaker 01 Mm hmm.
27:28 Speaker 02 And I think just understand that there's not an exact correlation between how hard you hit your head and the impact that it has on your brain. And like I was saying before, it is who you are. It's the most important organ, in my biased opinion. And you really should be putting very, very high priority on getting it checked out.
27:49 Speaker 01 That is Dr Lewis Fried. He's now training as a psychiatrist in Sydney. You also heard from Kate from WA, as well as Dr Nazanin Verji Babbel, who is a physical therapist, neuroscientist and associate professor at the University of British Columbia, and Shreya MacLeod, physiotherapist and lecturer at Australian Catholic University. Shreya's also doing her PhD in sport-related concussion at the University of Newcastle. Now, one thing we didn't get into in this episode was how concussions are a bit different in children. They can take a lot longer to recover.
28:25 Speaker 04 You have this very active, dynamic stage of development that's going on in the brain. And then all of a sudden you have an injury, you know, your brain now has to not only reroute and recover, but it also has to continue with the development. And I think that's why it takes longer.
28:42 Speaker 01 So just something to keep in mind if you have little ones at home. And that's it for All in the Mind this week. Thanks to producer Rose Kerr and sound engineer Russell Stapleton. I'm Sana Qadar. Thanks for listening. I'll catch you next time.
28:58 Speaker 06 Ever get so mad you can feel your blood pumping in your veins? Or so happy that it's like someone put a serotonin filter on the world? We have so many emotions that impact not just our mood, but our behaviour too. So who's in control? You or your emotions? My name is Dr Nige and I host Imagine This, a science podcast for curious kids and their grown-ups about the questions you probably always wondered but never actually known the answer to. Like...
29:29 Speaker 07 How do spiders and snakes make their venom? How is glass made? Why do we have emotions?
29:37 Speaker 06 Imagine This is a podcast for kids, but there's answers on there for everyone. So share it with any little ones in your life or listen to it together. You'll learn something new on Imagine This. Find it on the ABC Listen app or wherever you get your podcasts.
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