But all that changed 41脷2聽years ago, when Gabriel flew off her bicycle and struck concrete head-first. Her helmet may have saved her life, but the 35-year-old still struggles with the long-term effects of her brain injury and has been unable to return to work.
Gabriel has energy for no more than three hours of concentration a day before she needs a nap or rest. Her home is dimly lit and she wears earplugs at all times.
鈥淚t鈥檚 mostly the headaches,鈥� Gabriel said. 鈥淵ou are already so on the edge of maintaining composure, so when there is noise, it is just too much.鈥�
Nevertheless, it took 31脷2聽years before doctors recognized she had sustained a brain injury. Gabriel doesn鈥檛 blame them. She said the injury left her too befuddled to tally up all her symptoms for a one-time presentation: memory loss, nausea, poor balance, ringing in the ears, headaches, confusion and constant fatigue.
鈥淚t鈥檚 not like I would even remember to go into my GP and say, 鈥業 have all these symptoms鈥� because I wouldn鈥檛 remember to say 鈥業 have all these symptoms,鈥� 鈥� she said.
One day, however, she talked to another brain-injury survivor who recommended she check out the Victoria Brain Injury Society, which has programs to help people deal with long-term effects. Gabriel is now on the society鈥檚 client list, which has grown by about 50 per cent in the past 18聽months, from about 500聽to 750, as understanding of concussions and brain injuries increases.
Doctors and brain-injury specialists trace that growing awareness to media reports about injuries suffered by professional athletes such as hockey player Sidney Crosby. The National Football League has also seen former players struggle to deal with long-term concussion symptoms and launch lawsuits against the league.
Shelina Babul, a sports-injury specialist with B.C. Children鈥檚 Hospital in 91原创 who focuses on concussions and brain injuries, said work in the field has been ongoing for the past decade. But in Canada, in particular, it wasn鈥檛 until hockey heroes started falling that the public took serious notice.
鈥淚t really was Sidney Crosby鈥檚 injury that raised the public profile,鈥� Babul said in a telephone interview. 鈥淵ou turn on the TV or open the newspapers and you see something more being added.鈥�
A concussion occurs when a sudden knock or jerk of the head moves the brain inside the skull, where it rests in spinal fluid. Typically with a concussion, the disruptive stirring inside the fluid leaves no detectable, structural damage to the brain. Sufferers usually recover in three to six months.
But Dr. Claire Sina, a psychologist with the 91原创 Island Health Authority, classifies brain injuries as something different. Symptoms may be similar 鈥� confusion, blurred vision 鈥� but a brain injury usually involves structural damage to the brain. A bleed or a bruise, detectable on medical scan, is often present.
鈥淲e separate concussions from a mild traumatic brain injury, a moderate traumatic brain injury and a severe traumatic brain injury,鈥� she said.
Also, the concussion, while stressful, is an event from which a person usually recovers, providing the patient rests, physically and mentally, for a long enough duration.
Brain injuries and concussions often occur because of a sudden decrease in speed 鈥� hitting the head on pavement after flying off a bicycle, being in a car accident or slamming into the boards or taking a body check in hockey.
New research shows that in children, this brain movement can be even more catastrophic than in adults. A child鈥檚 head, relative to the entire body, is proportionately larger than an adult鈥檚, so sudden deceleration can cause more significant movement. A child鈥檚 skull is also thinner and less resistant to blows. Additionally, neural pathways inside the brain are still being developed, and an injury can disrupt that development.
Unfortunately for the brain-injured and concussed, symptoms vary widely. Two people exactly the same age and size can sustain the same blow in the same way. But recoveries can differ widely.
Why?
鈥淭hat鈥檚 the $64-million question,鈥� Babul said.
But strides have been made, she said. Physicians, sport coaches and the public have become more aware of concussion dangers, causes and treatment.
Protocols have been developed to determine if an athlete can return to games or workouts. There are checklists for doctors to determine the likelihood of brain injury. Employers and employees are beginning to realize a return to work after a concussion should be gradual and slow.
鈥淭en years ago, you hit your head and were told, 鈥極h, you just had your bell rung, you鈥檒l be fine in a couple of days,鈥� 鈥� Babul said.
Complete physical and mental rest is essential until symptoms disappear. Activities such as reading, watching TV or studying for an exam fire up the brain and make it difficult for natural repairs to occur.
Coaches and parents are told not to push a young person back into games before they鈥檙e ready.
鈥淟isten to your kids, if they are hurt or injured,鈥� Babul said.鈥淒on鈥檛 push them.鈥�
Nicole Nelson, director of resource development at the Victoria Brain Injury Society, says the group has a wait list for the first time since it was formed in 1983, with about 40 people waiting for help.
The wait list is a real problem, Nelson said, because those with brain injuries are often well along a downward spiral before they even show up at the society.
In her experience, recovery from brain injuries can can take years. Symptoms can last indefinitely.
Unable to concentrate, stay alert or keep their memory functional, the brain-injured often can鈥檛 return to work. They lose their jobs. Debts can鈥檛 be serviced. Mortgages are foreclosed. Depression takes hold. Marriages split. Friends disappear. Substance abuse often occurs.
鈥淔or me to say to someone who has lost their wife, their home, their job, their friends and is now struggling with an addiction, 鈥業鈥檓 sorry, you have to wait three months鈥� is just impossible,鈥� Nelson said.
鈥淚t can take some people years to get back on solid ground 鈥� years,鈥� Nelson said. 鈥淎nd we are talking about people who have had high-functioning, high-level jobs who鈥檝e had their brain injury and now can鈥檛 work more than two hours a day.
鈥淚t鈥檚 devastating for them.鈥�
> Physical contact in sports can have devastating effects on the brain, C11
