Rock Hill doctor brings first-hand knowledge to treating concussions

Smitha Ballyamanda vividly remembers her first concussion.

She was playing soccer and jumped to “head” the ball to a teammate, who scored. As she was about to land her head collided with a rising defender, breaking her nose.

She started tearing up, her head was throbbing. Instinctively she grabbed her nose. Much later in life she realized she had set her own broken nose – and had symptoms of a concussion.

Her adrenaline was rushing, “I didn’t want to stop,” she said.

The referee stopped the game. “There was blood all over me,” she said. She had torn an artery in the collision.

The next day Ballyamanda was back at practice. No one raised a concussion concern.

Athletes nationwide will be watching the movie “Concussion” on its Christmas Day opening. The movie tells the story of Dr. Bennet Omaju, played by Will Smith, who diagnosed degenerative brain disease chronic traumatic encephalopathy (CTE) in deceased NFL players who had experienced repeated concussions.

Ballyamanda’s interest is more than as an athlete. As a doctor board certified in family practice and sports medicine, she see the effects of concussions in her patients at Piedmont Medical Center’s Sutton Road Urgent Care.

She acknowledges that Hollywood resorts to “hype” to make movies. But she hopes that people who see “Concussion” leave the movie with an awareness of the seriousness of concussions, and the effect on the body of subsequent concussions.

Her concussion experiences – she said she had several while playing – helps her understand an athlete’s outlook, the desire to get back in the game. But if there are symptoms of a concussion, athletes need to wait, give their brain time to heal, she said.

Brain rest means no action movies, no texting, no video games, “nothing that is high impact stimulus. If you are very bored you are doing the right thing,” she said.

A concussion is defined as a “complex pathophysiological process” that affects the brain. In simple terms, it is either a direct blow to the head or an indirect blow to the body which induced trauma, with brain tissue hitting the skull, resulting in swelling. Symptoms may be physical such as headaches and nausea; cognitive such as difficulty in concentrating; emotional or body maintenance such as changes in sleep, appetite or energy. You don’t have to “pass out” to have a concussion.

The latest Sports Concussion Assessment tool, SCAT3, includes a wide range of physical and cognitive tests. Among the tests is one that assessed immediate memory. Ballyamanda will ask a patient to repeat five words, “blue, candy, train, pebble and apple.” She will also ask them to repeat a series of numbers in verse order. She starts with 8-0-3 and adds a digit each time, until she reaches six numbers.

If a concussion is diagnosed, Ballyamanda prescribes “brain rest.” There is no standard recovery time. Some people recover quickly, others take longer. Age, health and how people take care of themselves after the injury affect recovery.

The recovery protocol for athletes requires them to be symptom free for 24 hours, followed by a five-day period where they gradually work themselves toward playing conditions. If they experience a relapse in symptoms, the protocol starts over.

Recovery means an athlete could return to contract sport. But research suggests that even a person with one concussion is one to two times more likely to receive a second concussion.

With two concussions, people are two to four times more likely to have multiple concussions.

The more concussions, the more possibility of intense effects on the body. Ballyamanda recalled treating one wrestler who already had seven concussions. Once a straight “A” student, the wrestler was struggling to concentrate, his grades were falling.

While it was a difficult discussion, Ballyamanda suggested that, for his health, the wrestler not compete.

“It didn’t mean no sports for him, just no more contact sports,” she said.

This story was originally published December 24, 2015 at 2:09 PM with the headline "Rock Hill doctor brings first-hand knowledge to treating concussions."