montreal general hospital – The Concordian

The most dangerous part of having a concussion is going back to the game when the brain hasn’t fully healed.

Dr. Simon Tinawi, a physiatrist at the Montreal General Hospital, said concussions in contact sports are extremely common.

“Connections in the brain’s white matter, not necessarily in neurons, but in axons, which are the connections between one neuron and another, are disturbed,” said Tinawi, explaining what happens inside the brain during a concussion. “So nerve conduction velocity slows down, which is why people feel they’re not performing well.”

Tinawi added that if a connection must go from a neuron A to a neuron B, but is disturbed, it could go from A to C, and then from C to B, making a detour to finally connect with the right neuron. This means it’s a slower process and it’s the reason why, in general, people feel different after a concussion. They might be less focused, have headaches, and feel nauseous.

According to Mayo Clinic, other symptoms of a concussion could include ringing in the ears, vomiting, blurry vision, fatigue, dizziness, amnesia, and confusion or “feeling as if in a fog.”

Tinawi said that there is a lot of confusion between a concussion and a traumatic brain injury (TBI). TBIs are ranked as mild, moderate and severe, but concussions don’t use the same ranking system. A concussion is defined as a mild TBI.

According to The Centers for Disease Control and Prevention (CDC), a concussion is caused “by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth.”

Yet, a severe TBI can be caused by a fractured or crushed skull and can cause hematomas, or internal bleeding, which might require surgery in significant cases. In general, a concussion requires some rest and heals on its own.

Shanellie Marie Desparois, a student at Concordia University, said she got a concussion while doing Kyokushin Karate when she was younger.

“It was a mawashi kick, which kind of hooks your head with the foot. It was actually my favourite kick later on,” she joked. “You have headgear but it doesn’t really protect you from impact. I remember getting kicked in the head really hard […] and my brain kind of shook extensively. I could see little dots and I felt like I was going to pass out. Then 10 minutes after, I started throwing up.”

After the doctor told Desparois she had a concussion, he told her to rest and not to sleep for a few hours. She said she remembers her mother keeping her up for the rest of the night.

“After a concussion, the brain remains sensitive,” said Tinawi. “So returning to sports early while the brain hasn’t healed properly can be dangerous. We can see that, for example, if an athlete has a concussion playing a contact sport and gets back to the game too early, getting another hit on the head can be extremely dangerous. It can cause swelling and other serious complications. We call that second-impact syndrome (SIS).”

For these reasons, Desparois waited two months before fighting again or doing anything that could impact her head. She was only attending classes and doing warm-ups.

Concussions occur in all sports, especially contact sports such as football, hockey, and rugby, according to Brainline. Tinawi said that concussions are also common in boxing, soccer and martial arts.

Yet, the University of Pittsburgh Medical Center shows that 50 per cent of concussions go unreported or undetected.

Alexi Dubois, another Concordia University student and centre for the NDG Cougars, said he might have gotten a concussion playing hockey last year.

“I was in the corner and got hit from behind so I went head first into the boards,” said Dubois. “I did not go see a doctor because I wasn’t sure if I had a concussion and I didn’t think it was worth waiting in the emergency room for six hours to be told to lay in bed for a few days.”

Dubois added that he had no major symptoms of a concussion, such as nausea, or dizziness. He said he had headaches for a week, but didn’t stop playing other than missing one practice.

Gabriel Guindi, a Concordia University student, said he might have gotten a concussion while playing hockey.

“I’ve received pretty bad hits on the head so maybe I had one but I was never diagnosed,” he said.

Dubois and Guindi both didn’t see a doctor after a possible concussion because they believed it wasn’t too serious.

To assess if an athlete has a concussion, doctors use the SCAT 5, which is a test that helps asses if a person has a concussion during a sport. Tinawi explained that it helps determine if a person is confused or not and if they can tell what happened. Physical examinations are also required.

The CRT 5 is also available for non-professionals to recognize if someone just got a concussion. As well, according to Tinawi, if an athlete shows any symptoms of a concussion, it is important they rest and go to the doctor as soon as possible.

Scheduling conflicts and staffing issues are only some of the problems patients experience

On Feb. 18, my 87-year-old grandmother slipped on ice outside her apartment, breaking her right elbow. I wish I could say that’s where the problems stopped. After the fall, my grandma was rushed to the Montreal General Hospital. It’s unfortunate the Lakeshore Hospital was backlogged—it would have been a much shorter ambulance ride for her.

Once my grandma arrived at the Montreal General, she was placed in the ICU and had some X-rays done. Two days later, she was sent home with a temporary cast that looked like it was made out of a half-roll of toilet paper and a few bobby pins. What she didn’t know was that it would take over a week to have surgery, which was imperative because her elbow joint was broken and she had multiple fractures in her arm.

The surgery was scheduled at the Montreal General for Feb. 22. My grandma and my aunt headed down there only to find out, eight hours later, that there had been a mistake with the scheduling—no doctors were available to do the surgery. A whole day spent in a waiting room with a broken elbow, and a scheduling error pops up? Not a problem—my grandma will just have to sit in her apartment in pain and wait until her surgery can be rescheduled.

According to an article in the Montreal Gazette in June 2016, 232 Montreal cancer patients had been waiting at least two months for surgery as of May 28. It’s clear I am not the only one experiencing issues with the Quebec healthcare system.

My grandmother was eventually scheduled to have her surgery eight days after the fall, on Feb. 26. After the surgery, she was sent home with my aunt who would look after for the next few weeks. The hospital arranged to have a CLSC nurse sent to her house for physiotherapy until her injury healed. Yet, a nurse never came because the hospital was backlogged, and nurses were scarce or none. There are private nurses you can hire for an average fee of $120 per hour, and that’s what my grandma did.

But $120 per hour for one hour, twice a week for two weeks is a lot of money when all you have is one pension. After racking up a bill of $500, my grandma couldn’t afford it anymore. She arranged for free physio at the hospital once a week.

Now, I could write a long list of things that are wrong in the healthcare system in Quebec, but if you live here, you probably already know that. Heck, if you’re reading this right now, I’m sure you’ve had an unpleasant experience with the system at some time in your life.

If you Google “Montreal healthcare system,” you can see for yourself how many negative articles come up regarding surgery delays and staff shortages. Now mid-March, my grandma has just begun her physiotherapy treatment at the Lakeshore Hospital. She has finally been treated by a nurse.

According to an article in the Montreal Gazette, “poor hospital organization is part of the problem, but so is a lack of flexibility on the part of doctors. While 90 per cent of hospitals can easily add nursing staff to cope with overflows, 75 per cent are unable to adjust doctor schedules on short notice.” It seems that scheduling conflicts and short hospital staff is a problem. One solution would be to create a long-term plan for the scheduling of more Quebec doctors into hospitals.

Based on the personal experience of my grandmother’s recent accident, scheduling at the Montreal General Hospital seems to be disorganized. If you ever have an accident and need emergency attention, I recommend you try to plan out the accident ahead of time.