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Protecting the Brain Against Concussion May 1, 2010

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Neurophsychologist and neurotic mom Kim Gorgens talks about how kids are prone to sustaining concussion from the most taken-for-granted everyday activities.

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So, a funny thing happened on my way to becoming a brilliant, world-class neuropsychologist: I had a baby. And that's not to say I ever went on to become a brilliant, world-class neuropsychologist. Sorry TED. But I did go on to be a reasonably astute, arguably world-class worrier. One of my girlfriends in graduate school, Marie, said, "Kim, I figured it out. It's not that you're more neurotic than everyone else, it's just that you're more honest about how neurotic you are."

So in the spirit of full disclosure, I brought some pictures to share. Awwww. I'll just say, July. (Laughter) Zzzzzzip for safety. Water wings - an inch of water. And then, finally, all suited up for the 90-minute drive to Copper Mountain. So you can get kind of a feel for this. So my baby, Vander, is eight years old now. And, despite being cursed with my athletic inability, he plays soccer. He's interested in playing football. He wants to learn how to ride a unicycle.

So why would I worry? Because this is what I do. This is what I teach. It's what I study. It's what I treat. And I know that kids get concussed every year. In fact, more than four million people sustain a concussion every year, and these data are just among kids under 14 who were seen in emergency rooms. And so when kids sustain a concussion, we talk about them getting dinged or getting their bell rung, but what is it that we're really talking about? Let's take a look.

All right. "Starsky and Hutch" arguably. Yes. So a car accident. 40 miles an hour into a fixed barrier - 35 G's. A heavy weight boxer punches you straight in the face - 58 G's. In case you missed it, we'll look again. So look to the right-hand side of the screen. What would you say? How many G's? Close. 72. Would it be crazy to know, 103 G's. The average concussive impact is 95 G's. Now, when the kid on the right doesn't get up, we know they've had a concussion.

But how about the kid on the left, or the athlete that leaves the field of play? How do we know if he or she has sustained a concussion? How do we know that legislation that would require that they be pulled from play, cleared for return to play, applies to them? The definition of concussion doesn't actually require a loss of consciousness. It requires only a change in consciousness, and that can be any one or a number of symptoms, including feeling foggy, feeling dizzy, hearing a ringing in your ear, being more impulsive or hostile than usual.

So given all of that and given how darn neurotic I am, how do I get any sleep at all? Because I know our brains are resilient. They're designed to recover from an injury. If, God forbid, any of us left here tonight and sustained a concussion, most of us would go on to fully recover inside of a couple hours to a couple of weeks. But kids are more vulnerable to brain injury. In fact, high school athletes are three times more likely to sustain catastrophic injuries relative even to their college-age peers, and it takes them longer to return to a symptom-free baseline. After that first injury, their risk for second injury is exponentially greater. From there, their risk for a third injury, greater still and so on.

And here's the really alarming part: we don't fully understand the long-term impact of multiple injuries. You guys may be familiar with this research that's coming out of the NFL. In a nutshell, this research suggests that among retired NFL players with three or more career concussions, the incidents of early-onset dementing disease is much greater than it is for the general population. So you've all seen that - New York Times, you've seen it. What you may not be familiar with is that this research was spearheaded by NFL wives who said, "Isn't it weird that my 46 year-old husband is forever losing his keys? Isn't it weird that my 47 year-old husband is forever losing the car? Isn't it weird that my 48 year-old husband is forever losing his way home in the car, from the driveway?" So I may have forgotten to mention that my son is an only child. So it's going to be really important that he be able to drive me around some day.

So how do we guarantee the safety of our kids? How can we 100 percent guarantee the safety of our kids? Let me tell you what I've come up with. (Laughter) If only. My little boy's right there, and he's like, "She's not kidding. She's totally not kidding." So in all seriousness, should my kid play football? Should your kid play football? I don't know. But I do know there are three things you can do. The first, study up. You have to be familiar with the issues we're talking about today. There are some great resources out there.

The CDC has a program, Heads Up. It's at CDC.gov. Heads Up is specific to concussion in kids. The second is a resource I'm personally really proud of. We've just rolled this out in the last couple months - CO Kids With Brain Injury. This is a great resource for student athletes, teachers, parents, professionals, athletic and coaching staff. It's a great place to start if you have questions. The second thing is speak up. Just two weeks ago, a bill introduced by Senator Kefalas that would have required athletes, kids, under 18 to wear a helmet when they're riding their bike died in committee. It died in large part because it lacked constituent buy-in, it lacked stakeholder traction. Now I'm not here to tell you what kind of legislation you should, or shouldn't, support, but I am going to tell you that, if it matters to you, your legislators need to know that.

Speak up also with coaching staff. Ask what kind of protective equipment is available. What's the budget for protective equipment? How old it is? Maybe offer to spearhead a fundraiser to buy new gear. Which brings us to suit up; wear a helmet. The only way to prevent a bad outcome is to prevent that first injury from happening. Recently, one of my graduate students, Tom, Tom said, "Kim, I've decided to wear a bike helmet on my way to class." And Tom knows that that little bit of foam in a bike helmet can reduce the G-force of impact by half. Now I thought that it was because I have this totally compelling helmet crusade, right, this epiphany of Tom's. As it turns out, it occurred to Tom that a 20-dollar helmet is a good way to protect 100,000-dollar graduate education. (Laughter)

So, should Vander play football? I can't say no, but I can guarantee that every time he leaves the house that kid's wearing a helmet - like to the car, or at school. So whether athlete, scholar, over-protected kid, neurotic mom, or otherwise, here's my baby, Vander, reminding you to mind your matter.

Thank you. (Applause)

Courtesy of TED

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- Kim Gorgens
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