On The Level
A Quarterly Newsletter of the Vestibular Disorders Association
By Jennifer Liss (with Sherron Laurrell)
There are all kinds of events that have the potential for disrupting our lives. A near fatal car accident certainly fits that description. A resulting concussion interrupts life for both the sufferer and for those who love them.
That is exactly what Deana Leonard faced on a December afternoon in 2014. As she and her mother were on their way Christmas shopping, a man “late to work” blew through a red light and hit their car on the driver’s side, demolishing the front end. Deana’s mom was injured by the seat belt and fortunately healed without issue. Deana, however, was not so lucky.
After the collision, Deana jumped out of the car and instantly felt nauseous. Her head was hurting. Her focus was on her mom. And she was scared! The police wanted her to go to the hospital. She said “no.” She was terrified, she thought, but not hurt. She just wanted to go home and go to bed.
Two days later she was “talking crazy” and not making any sense. Her husband and her twin sister began insisting that she go to the hospital but she continued to resist. Finally they didn’t offer her the choice. When they arrived at the ER the doctors asked why she had waited. They ran tests and did a CT scan and then told her, “You have concussion like symptoms. You need to follow up with a neurologist.”
On December 19th, Deana saw a concussion specialist at The Children’s Hospital of Philadelphia (CHOP), who confirmed that Deana had a concussion. “Time is your friend Deana, but vestibular rehabilitation therapy will help you recover more quickly.”
When Deana came to see me, she felt like her head was in constant motion. Clinically she presented with motion sensitivity, dizziness, imbalance, light sensitivity, head pressure and cervical stiffness. Her injuries were the result of the air bag deployment. During the balance exam her BESS (Balance Error Scoring System) score was a 22 (normal is 10 or less); her timed heel/toe walk (10 feet with turn) was 21 seconds (normal is less than 14 seconds without losing balance). Her MSQ (motion sensitivity quotient) showed a severe handicap at 52 percent. All other tests supported the finding of concussion. Her first appointment with me was December 31, 2014, seventeen days after her accident.
She had continual dizziness and balance issues over the holidays, but being a mom she didn’t want to spoil the Christmas season for her two children, Megan, age 14 and Brett, age 9, by starting VRT. For many years before her accident, Deana had suffered from moderate to severe car sickness. Concussions can exacerbate previously existing conditions. After a thorough examination and case history I was able to say to Deana, “I have good news for you. After you complete VRT, you will feel better from the concussion and your long standing motion sickness issues may subside too!”
Deana began VRT twice a week at my office with homework she did on her own. It was a struggle at first. She continued to have severe headaches for the first few weeks. As her vestibular rehab progressed she began to feel better. When
she went for her check-in with the concussion specialist at CHOP in early February she was able to report that she felt much better – fewer headaches, more balanced.
As a middle school guidance counselor, Deana tried not to miss too much work. In total she missed only six days. Her principal was very supportive of her situation. Her students were terrific! In her role, she had always handled accommodations of concussion cases for students but now she has a deeper appreciation of how to coach teachers who “resist” the reality that a concussion is serious business.
Her advice to others? If you are in a car accident, GO TO THE HOSPITAL! Don’t wait. Concussions are no joke!
Deana graduated from VRT on April 30. She is doing well and is grateful that her fear that she would never be normal again has been replaced with regained balance and no car sickness!
Jennifer Liss is “Susan Herdman certified” in Vestibular Rehabilitation. She is an Adjunct Professor of Kinesiology at Rowan University in Glassboro, NJ. TheraSport Physical Therapy offices are located in New Jersey, where she has practiced for 16 years. She can be reached at JenLiss@Therasport.org.
Sherron Laurrell is a vestibular patient who has been treated by Dr.Liss. They now collaborate on case studies to educate and help others.