Winning Isnít Worth Your Health

In a culture of masculinity, being seeing as tough or manly has worth. Shaking it off or putting dirt on it after an injury means toughness, or an attitude that a little pain or a small injury wonít stand in the way of what needs to be done. But while this ethos has helped create a result-oriented culture, the cost has often been the health of the individual. One of the ways this has shown itself is with brain injuries.

Second Impact Syndrome

Second impact syndrome (SIS) is an injury that mostly affects athletes and people in extremely physical occupations and has the potential to result in death. It occurs when, before a concussion is healed, another concussion occurs, and is most prevalent in areas that value the perception of toughness.

Where and Why

An example is, if all things are equal, two employees on a construction site working on a tight deadline suffer concussions. The one most willing to begin work again has more value to an employer for obvious reasons, in that an extra set of experienced hands will help get the job done on time. But the dangers of coming back to work too soon often far outweigh the rewards of being seen as an eager worker.

This attitude is especially prevalent in the sports world. Famously, Ronnie Lott, an all-pro safety for the San Francisco 49ers, opted in 1985 to have the tip of his pinky finger amputated instead of having it fixed because the recovery time was less. Unfortunately, this attitude is far from uncommon among athletes, who are usually extremely competitive. Waiting for a concussion to heal takes time, while playing immediately may decide a win or loss. However, while coming back early may win games, it can also shorten lives.

The Risks

While SIS is extremely rare, it does nonetheless represent a real and very deadly risk most commonly associated with individuals who live an extremely physical lifestyle. While a concussion alone is dangerous, two consecutive concussions, the second before the first one has healed, can be life-threatening. According to the National Institutes for Health (NIH), death can occur within minutes.

What Happens

It's suggested that SIS occurs because ďthe brain loses its ability to auto regulate intracranial and cerebral perfusion pressure. This may lead to cerebral edema (severe swelling of the brain) and possible brain herniation. Loss of consciousness after the initial injury followed by secondary brain damage creates ionic fluxes, acute metabolic changes, and cerebral blood flow alterations. All of these characteristics enhance the vulnerability of the brain and greatly increase the risk of death, even if the second injury was far less intense.Ē [Source: Newsome Melton LLP's BrainandSpinalCord[dot]org].

Discovery and Statistics

SIS was first identified in 1984 and is still surrounded by controversy. The rarity of its occurrence is one of the issues. A study by the National Center for Catastrophic Sports Injury Research, focusing on high school and college football players between 1980 and 1993, identified only 35 probable cases, with only two of those at the college level. However, criticism suggests the number may be much higher if the statistics included football played by Australian rules, which averages eight times as many concussions as American football. There are no studies from Europe, despite recent attention being given to head injuries from headers in soccer. Still, recent studies concerning head injuries in NFL football players has brought needed attention to head injuries in general, and more resources are being used to study the effects.

Treatment and Prevention

As of now, the NIH suggests treatment for SIS includes stabilization and special attention to making sure the airway remains open, potentially including intubation. Medications can be used to reduce intracranial pressure, but the NIH emphasizes that more study is needed before any comprehensive treatment program can be recommended.
What is much more effective is prevention. Specifically, if someone has sustained a concussion, removing them from the sport or the job until the concussion is fully healed is recommended. An extra week of prevention is worth the risk of serious injury or death.

Billy Johnson and The Johnson Law Firm in Pikeville, Ky., are proud to bring their experience and resources to aggressively pursue your legal needs.

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Disclaimer: While every effort has been made to ensure the accuracy of this publication, it is not intended to provide legal advice as individual situations will differ and should be discussed with an expert and/or lawyer. For specific technical or legal advice on the information provided and related topics, please contact the author.

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