Vivienne Gray doesn’t fit the same profile as former or current professional athletes forced to live with the ongoing effects of concussions.
The 33-year-old cardiac care nurse has been attempting to cope with the side effects of a concussion sustained during a collision with an opposing player in an inline hockey game nearly two years ago.
She fell and hit her head on concrete and doesn’t remember being knocked out from the collision -- although a video showed she was unconscious. A day later she started feeling nauseous and had “weird” and incapacitating headaches that wouldn’t go away.
Five days later she saw her doctor, and that’s when potential brain damage from the hockey collision became apparent.
As a nurse, she often witnessed patients doing so-called higher cognitive tests, like counting backwards from 100 in multiples of seven or reciting the months of the year backwards.
As a healthy nurse, she had always done the tests along with the patients, and passed with flying colors.
“But I knew something was amiss when my doctor asked me to do the same,” Gray said in an interview with The Associated Press. “I didn’t fare well at all. I didn’t even make it back to October.”
Gray's doctor is Nicole Higgins, who is also president of the Royal Australian College of General Practitioners. This week her group warned government and sporting bodies in Australia that they must do more to limit the long-term impacts of concussions and repeated head trauma.
The group has submitted a report to an Australian Senate inquiry into concussions and head trauma in contact sports. It's more aimed at the grass-roots level that GPs often have to deal with, like Gray's case.
Funding for more research is a key part of the report.
“We are learning more and more about the management of prolonged concussion symptoms, such as post-concussion syndrome and suspected chronic traumatic encephalopathy which many people may recognize from an increasing number of concerning media reports," Higgins said
In Australia, those reports included the death of star Australian rules football player and coach Danny Frawley. Last year, a Victoria state coroner recommended that Australian Football League players be encouraged to donate their brains post-mortem to science to help further the understanding of CTE, a degenerative brain disease found in people with a history of repetitive brain trauma.
Frawley, who'd been suffering from anxiety and depression, died at the age of 56 in a car crash in 2019 and a post-mortem examination revealed he had CTE, which can only be diagnosed by autopsy.
“CTE must be taken extremely seriously, and it isn’t just something that we need to worry about in adult sport, damage to the brain can happen at an early age whenever there are repeated knocks to the head," Higgins says.
The effects of concussions on athletes in professional contact sports is well-documented. Boston University CTE Center has done studies which show that more than 300 National Football League players have developed chronic traumatic encephalopathy.
“My job as a GP is to prevent and pick up any more complicated issues down the track," Higgins says in an interview with the AP. “There is no such thing as ‘it's just a little knock.'" She said someone with even an apparent minor injury can have more complex reactions in the future.
Many professional sporting codes have allocated resources to illustrate the dangers of concussions and their long-term effects, including the NFL, World Rugby and England Rugby.
Higgins has a son and two daughters who play Australian rules football and netball and a husband who coaches and has played Aussie rules. So she's spent many afternoons and evenings on the sidelines watching young athletes in action.
“As a GP and a parent of children who loves contact sport, I can tell you that we certainly don’t want kids and adults walking away from contact sport and sitting on the couch," Higgins says. "This must be taken seriously.”
Gray, who lives in the Queensland state regional city of Mackay, where Higgins is also based, is still struggling with her illness.
She still has difficulty multitasking — walking and talking, eating and conversing, singing and reading music. She has what she calls “fatigue and malaise" and “decreased lack of executive functions — self control, emotional control, task initiation, working memory . . . planning and time management."
“It’s affected my ability to work, run errands, participate in hobbies, socialize and my relationships with friends and family — who are very supportive and caring," Gray adds.
She began a graduated return to work in January 2022 but the six hours she had planned to work every day “broke my brain” and she realized she had pushed too hard to return to work.
“I got to the stage where I realized I was burning out, and I had overdone it,” she said.
Now she works three days a week for four hours a day and has what she calls a “multi-disciplinary approach” with her treatment.
“GP-directed care, psychiatrist, physiotherapy, massage, chiropractor, behavioral optometrist . . . and regular psychology reviews," she says. She formerly saw a neurologist and occupational therapist.
More research, like the GP group is recommending, will help determine what works and what doesn't.
“More light is being shed on it because with everyone being so different, there is no gold standard for treatment,” Gray says. “My doctors have said I’m doing all the right things to aid my recovery. The length of recovery time is uncertain . . . it will be slow and will be seen with time."
