Head Injury

Hello All.  It has been quite a while.  Lots of things developing lately…i will announce when ready.  Recently something happened, and how I reacted, reflects on how differently we osteopathic physicians assess and look at a situation.  Hopefully by sharing this episode, the broader public can assess their current health situation in context and compare between MDs and DOs.  Four days ago, I received a call from my chidren’s daycare.  You need to come.  Something happend to Kathleen.  What happened? You just need to come and pick her up.  Another kid ran into her on his bike.  Her head whacked the handle bar and she had this gigantic blue lump on her forehead the size of an egg…really it was quite a chickenegg.  The skin was scraped so thank goodness I did not have to sew her up.   My best friend, who is also a pediatrician with her kids in the same school prods me.   Did K hit the kid or did the kid hit K?  Her little one “saw the whole thing,” told her mommy that he did it and that K was the innocent bystander.  My best friend was really concerned and freaked out, more so than I.  The next day when i went in to drop her off, the staff was very nervous.  Her teacher who was present and watching the kids, felt so bad, she was crying and very apologetic.  I said to her, “Ahh, its okay. I’ve seen worse.  Accidents happen.” Really…I’ve seen worse…concussions, gigantic gaping cuts that lead to thick scars, etc…besides, the worst brain injuries happen when the force is transmitted deeper and absorbed by the skull or neurons; if her skin and scalp is bruised than, logically, it took most of the force and some minor residue is absorbed internally…better that than a “brain bruise,” i.e., concussion with brain swelling risks…  I let it pass.  I think everybody thought that I would flip out, threaten them and expect some head rolling.  Even my best friend was suprised at how lightly I was taking this.  She called me the next day and said that she was amazed at how Kathleen was healing.  Overnight, the lump and swelling practically went away.  It could have been the 2 doses of arnica that we gave her that night…but I suspect that she drained well simply because her head had been treated in the past.  Today, 4 days post injury, she is already starting to get the raccoon eyes when blood in the injured tissue starts to break down and ooze underneath the skin and bruising appears around the eyes (usually takes about a week).  My friend, who is an MD, whose two kids have great big giant melons, and traumatized ones at that, have really hard heads consequently, had never seen such quick resolution.  (I should have taken pictures…next time…told her to do the same for her kids and we will compare).  She was suprised that I was unfazed by this event.  She stated that if it was her kid she would be completely freaked out, paranoid and upset and try to get to the bottom of the cause of this accident.  I said accidents happen all the time…we see it…it will not be her only one…besides…she going to be smart-er for it…???????what?????how did you arrive at this conclusion???? you want her to have head trauma??? no…of course not…if it happens, if its minor, i’m not going to fuss over it.  Kathleen is already smart, primarily because of good genes and secondarily because she has an intact family with social support and involvement; everyone who comes in contact with her comments on how bright she is.  I proceed to explain that she took a blow to her forehead, frontal lobe, location of executive function.  The pressure and force of the trauma shocked her system, the brain and all those lovely neurons, 6 layers of gray matter (in humans, 3 in monkeys).  The pressure will force the neurons to cope and adapt and form new connections.   I plan on waiting for 2-3 weeks to let the pressure build up before i decompress her head…once new connections are made, releasing the pressure will not make them ‘unconnect,’ i.e., they will be permanent…it is not the size of the brain that counts, or necessarily the number of neurons, but the complexity and number of connections between the neurons that count…Some of you may be agast at how I plan on caring for her…allowing “pressure to build up”…mind you i can wait because she is subclinical, meaning it has not (yet) affected her sleep, behavior, personality…believe me, if she showed any signs, i would certainly throw my plans out the window and intervene sooner…Read my prior post on how Genius is Made and you will hopefully get a clearer understanding…Just today I treated a teenager who slipped and fell and severely whacked his head that he immediately and for hours afterwards got a headache, very likely a mild concussion…I treated him immediately because I did not want him to suffer.  The traumatic force alone was probably enough to cause connection formation, so that it would continue even if i decompressed him enough to eradicate the pain of the pressure.  I told his mom this, and she commented that this was the most unusual of perspectives that she has heard about head injury…she commented that he always seemed to be a bit brighter than his peers, but that she had attributed this to his being a 7 month preemie…i agreed with her, that the gravitational forces upon a premature infant head causes it to be heavy and dense, sometimes misshapen, but that they do end up smart, the only problem is that they also have focus, attention and impulse control issues…now on the other hand, what happens to fully mature and formed brains that undergo a traumatic injury…less plastic, less pliable tissue, less likely to form new connections, but with the same or even worse tendency to vascular congestion? is it reasonable to postulate that the protein build up in the brains of alzheimer’s patients is not so much the result of a genetic tendency to excess production and deposition but rather, poor clearance and drainage of normal protein production?  how about those ex-football players now who have early dementia, or Mohammed Ali’s neurologic issues, how can these diseases not be linked to trauma? or that during a critical developmental period in autistic children, when they are still neurologically plastic, from past traumatic injuries, instead of forming connections of those few neurons, the are developing “garbage collecting” white matter cells whose sole function is to try and dispose of those proteins because the drainage can range from mildly affected or severly compromised (hence the ‘spectrum’).  Osteopathy is very common sense medicine.  The nerds in their ivory towers would rather attribute genes and genetics to a biochemical process of deranged excessive metabolism and engineer (pharmaceutically, genetically) a product that will interfere or disrupt those processes.  Ahhh…how about we undo the trauma, let the tissue drain itself, clear and heal itself…i like this way better because it is profound and far more beautiful in its precision as to…causation…and the patient can be whole again and not have to be forever dependent on any medical system or drugs or machines.  i think that most patients suffering and lost in the vast CMS (conventional medical system) would consider this perspective refreshing and appreciate its beauty and simplicity.   ADDENDUM:  today is 11/3/2012, 5 days after her head injury…Kathleen has been difficult, whiny, clingy and just plain unpleasant this whole day.  As in a prior post, emotional lability is a sign of traumatic head injury.  I checked her head tonight and it is completely whacked out.  She slammed her head pretty hard and the force was still fully impressed in her forehead and the front part of her skull and brain.  I treated her and she said that she felt better.  Poor thing! ADDENDUM: Kathleen is now 8 years old and we just had her parent-teacher conference.  Her teacher says that she likes math! Who knew?? Well, I kinda did…Maybe she likes math because I show her my shortcuts…Next real post, I will update you on her lisp and that tongue…still driving me crazy.

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