New research indicates that a small amount of bed rest is appropriate over the first 48 to 72 hours after a mild traumatic brain injury or concussion. The newest recommendations are to limit bedrest to no more than three days and encourage a gradual return to normal activities, as long as there are no obvious continued symptoms such as headaches, dizziness, nausea, poor balance or visual disturbances. Close monitoring for symptoms during the recovery period is critical.
Current recommendations for return to athletic activity follows a 6-step program, beginning 3 days after the initial injury with a return to normal school routines and light to moderate activity such as fast walking or riding a stationary bike. If there are no symptoms associated with this initial step, then there is a progression to moderate aerobic activity to increase heart rate and head movement, such as jogging, or sports skill related drills. If your student remains symptom-free, there is a stepwise progression to heavy aerobic activity, full unrestricted practice and finally a return to competition. In general, this process takes approximately 2-3 weeks, but should be guided by the managing physician in concert with either the athletic trainer or team coach. It is important to note that if symptoms do reoccur, the process would be restarted and require reevaluation by a physician who is familiar with concussion recovery programs. Most importantly, it is critical to understand that injuries to the brain can take a long time to heal and the treatment and recovery plan should be guided by a health professional knowledgeable of these types of injuries.
The pre-participation physical (often referred to as the sports physical or camp physical) is meant to identify a number of potential early warning signs that an athlete may have a more significant underlying health concern. We screen for visual problems, kidney function and diabetes in addition to cardiovascular and pulmonary symptoms. The key components to this process are providing the physician with honest responses to a series of questions meant to screen for potential heart ailments, including chest pain or discomfort with exertion, fainting spells, excessive fatigue or shortness of breath with activity. The second component is the physical exam, which specifically looks at blood pressure, heart rate and assessment for heart murmurs or abnormal breath sounds. If the history or physical exam reveals any potential heart or lung issues, then additional testing is recommended. Additional testing may be required If there are other signs and symptoms suggesting a possible problezm such as diabetes or kidney disease.
If additional testing is indicated, the clearance for participation may be delayed. Typically, additional tests for heart and lung symptoms may include a chest x-ray, EKG and possibly an echocardiogram (ultrasound exam of the heart), which is an excellent way to screen the heart for structural problems, without using any radiation. Starting September 24th, Lakes Urgent Care will offer echocardiograms for any patient where it may be indicated or in the event a parent wants their athlete screened because of a family history of heart problems such as cardiomyopathy (abnormal enlargement of the heart chambers). The echocardiogram may also be recommended if your student has abnormal blood pressure, any warning signs or symptoms or an abnormal EKG.
Under most circumstances, if your son or daughter just recently had a complete annual physical, your primary care physician will be happy to complete the required sports physical paperwork for you. However, if it’s after hours or you haven’t had that annual physical yet (which we always strongly recommend be done with your primary care physician or pediatrician), but need to turn in the paperwork, you can feel confident that Lakes Urgent Care will give your son or daughter a complete sports physical including additional testing if indicated. We always offer to share any evaluation or testing recommended or completed at Lakes Urgent Care with your primary care physician.
Yes, you should absolutely be concerned! The rate of Meningitis B is on the rise on many college campuses across the country. Students living in a dormitory have one of the highest risk factors for contracting this potentially deadly disease. If your student has other chronic health issues or is known to have immune system disorders, the risk is even higher. Meningitis B typically begins with cold or flu-like symptoms and rapidly progresses to a severe central nervous system and brain infection. Unfortunately, there is a 10% mortality rate in people who contract the disease, in addition to a 25% risk of serious long-term complications. The good news is that this severe illness can be prevented with a series of Meningitis B vaccines.
100% of all meningitis outbreaks on college campuses since 2011 have been from Meningitis B. The preventative vaccine is typically given in a series of 2 or 3 vaccinations over several months. Until recently, this vaccine was considered to be “elective” and not part of routine vaccinations that most children and young adults receive from their primary care physician or pediatrician. The CDC now recommends that all incoming college students receive a series of vaccines as a routine part of the transition from home to the college setting. This potentially deadly disease is completely avoidable by getting vaccinated. If you are unable to obtain the vaccine from your primary care physician, pediatrician or local health department, it is available at Lakes Urgent Care. Please make sure to plan adequately so that your college freshman has had at least 2 Meningitis B vaccine doses.
As your high school graduate looks forward to the college experience, there are some basic health tips you should discuss with her: developing good hygiene habits including frequent hand washing, assuring that all vaccinations that are necessary have been provided including the HPV vaccination, making sure that there is an awareness of local health care on campus or near campus, getting adequate sleep and eating a well-balanced diet. It’s also important to have open conversations about protected sex and a knowledge of how to prevent sexually transmitted diseases. Make sure that your college freshman has a good understanding about sexual abuse and violence that can occur in the college campus setting. Many college orientation programs address this issue, but this is a subject that should be transparently discussed and reinforced with your son or daughter.
Hives are small areas of swelling that occur on the skin surface in random areas on the body. Other commonly known names for hives include welts or urticaria. The medical term for hives is wheals. Hives typically appear very suddenly and may be pink or red with a raised surface around the edges with associated itching. The vast majority of hives last for a few minutes to a few hours, but in some cases can last for days, despite treatment. Rarely, hives can progress to a more significant allergic reaction that includes swelling of the tongue and throat with difficulty breathing, in which case they are potentially life-threatening.
Allergic reactions are the primary cause of hives. It can be difficult to determine the specific inciting factors, but there are numerous stimuli that can cause them to appear. Food products, plant contact or ingested medications can cause hives. Physiologically, they occur when there is a large histamine release in the body from specialized blood cells called mast cells. The histamines cause fluid to leak around the blood vessels in the area they appear leading to the skin changes that can be easily seen.