Let's get smart on what a concussion is.

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Re: Let's get smart on what a concussion is.

Postby tikidoc on Sun Apr 07, 2013 4:02 pm

Scott wrote:tikidoc,
or should I say mr Med Student.


1. I am not a medical student. I graduated from medical school in 1994.
2. I am not a Mr. Nice sexist assumption though. I suppose I shouldn't be surprised, given your "Suzy Homemaker" comment. News flash, women can be both physicians and hockey fans.

And you jumped to a whole lot of other conclusions regarding headaches. The primary issue I have been addressing is the fact that loss of consciousness with a head injury equals mild traumatic brain injury, AKA concussion. I mentioned headache in that it can also be a symptom of concussion. Certainly if someone has a headache after a head trauma, one should consider other causes, but persistant headache that started with the trauma and does not have another explanation would be considered evidence of concussion. As would nausea/vomiting, mental status changes, confusion, etc. But if you go back and read my post, I did not say that headache after head trauma always equals concussion. I said that it CAN BE a symptom. You are the one who made that an absolute.

With no loss of consciousness, you are correct in that it is not black and white. That is where clinical judgement and careful history taking is important, to try to tease out if the symptoms are caused by the head injury.

With loss of consciousness with associated head trauma, it absolutely is black and white. And that was the reason I posted the two definitions that have been published in peer-reviewed journals. That you are ignoring.
Last edited by tikidoc on Sun Apr 07, 2013 4:08 pm, edited 1 time in total.
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Re: Let's get smart on what a concussion is.

Postby LostPenguin on Sun Apr 07, 2013 4:08 pm

Scott: You need to quit now, while you're only half a mile behind.
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Re: Let's get smart on what a concussion is.

Postby MWB on Sun Apr 07, 2013 7:37 pm

Reading this thread just gave me a concussion.
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Re: Let's get smart on what a concussion is.

Postby Scott on Sun Apr 07, 2013 9:22 pm

tikidoc wrote:
Scott wrote:tikidoc,
or should I say mr Med Student.


1. I am not a medical student. I graduated from medical school in 1994.
2. I am not a Mr. Nice sexist assumption though. I suppose I shouldn't be surprised, given your "Suzy Homemaker" comment. News flash, women can be both physicians and hockey fans.

And you jumped to a whole lot of other conclusions regarding headaches. The primary issue I have been addressing is the fact that loss of consciousness with a head injury equals mild traumatic brain injury, AKA concussion. I mentioned headache in that it can also be a symptom of concussion. Certainly if someone has a headache after a head trauma, one should consider other causes, but persistant headache that started with the trauma and does not have another explanation would be considered evidence of concussion. As would nausea/vomiting, mental status changes, confusion, etc. But if you go back and read my post, I did not say that headache after head trauma always equals concussion. I said that it CAN BE a symptom. You are the one who made that an absolute.

With no loss of consciousness, you are correct in that it is not black and white. That is where clinical judgement and careful history taking is important, to try to tease out if the symptoms are caused by the head injury.

With loss of consciousness with associated head trauma, it absolutely is black and white. And that was the reason I posted the two definitions that have been published in peer-reviewed journals. That you are ignoring.


Wow. Let me see if I can help you with this. Nothing said whatsoever was sexist. Suzie Homemaker would be referring to just that. A homemaker. There is nothing wrong with that. The work is amazingly difficult and those who are should all get a medal. Joe six pack, and Jim lunch box...are they offensive too because that might indicate someone who drinks beer or eats too much? They are general terms to describe a certain type of person. Nothing more than that and you know. Don't you dare throw out the sexist card. You are better than that. Seriously!

In this thread it was brought up that the MAYO clinic says if you hit your head and get a headache then you have a concussion. It was quoted that if you have a blow to the head and have a symptom such as headache, dizziness, nausea or loss of consciousness then you have a concussion. I'm just conveying that a headache alone from any hit to the head does not lock in a guaranteed concussion.
As far as Neal getting hit he is going to be monitored moving forward and the proper procedure will take place.

When Sidney Crosby was dealing with the head problem his symptoms and recovery are different than you and I. Another teammate could take the same hit and keep on skating. Another teammate could take the same hit and never fully recover.

I echo again with head injuries there is no black and white. There are no guarantees with the symptoms and healing time.

From a medical point of view it is a daily work in progress to learn more and more about it every day.
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Re: Let's get smart on what a concussion is.

Postby Rylan on Sun Apr 07, 2013 9:25 pm

wtf happened here.

why can't we have concussion threads without people losing their minds?

just what the hell...
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Re: Let's get smart on what a concussion is.

Postby tikidoc on Sun Apr 07, 2013 10:09 pm

Scott wrote:Wow. Let me see if I can help you with this. Nothing said whatsoever was sexist.


What was sexist was the assumption that I was a man. And when someone who assumes that a medical professional must be a man (Mr. medical student, remember?) also references Susie Homemaker, it's probably a good bet that they have sexist tendencies.

The post about Mayo clinic was not mine, yet you attacked me for the content of that post (which was mostly correct, if maybe a little oversimplified). As far as the Mayo clinic site that was referenced, it is a site designed for patients/general public and therefore is going to be somewhat generalized and simplified. They are not going to go into the details of subtleties of diagnosing mild TBI.

But the peer-reviewed literature that I quoted is pretty clear. LOC + head trauma = concussion. At a minimum. That is black and white, and it is written in black and white. In the medical literature. Persistant headache that can't be explained with another etiology + head trauma is probably a concussion, but obviously that is more of a judgement call, and is not black and white.
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Re: Let's get smart on what a concussion is.

Postby Rylan on Sun Apr 07, 2013 10:17 pm

tikidoc wrote:
Scott wrote:Wow. Let me see if I can help you with this. Nothing said whatsoever was sexist.


What was sexist was the assumption that I was a man. And when someone who assumes that a medical professional must be a man (Mr. medical student, remember?) also references Susie Homemaker, it's probably a good bet that they have sexist tendencies.

The post about Mayo clinic was not mine, yet you attacked me for the content of that post (which was mostly correct, if maybe a little oversimplified). As far as the Mayo clinic site that was referenced, it is a site designed for patients/general public and therefore is going to be somewhat generalized and simplified. They are not going to go into the details of subtleties of diagnosing mild TBI.

But the peer-reviewed literature that I quoted is pretty clear. LOC + head trauma = concussion. At a minimum. That is black and white, and it is written in black and white. In the medical literature. Persistant headache that can't be explained with another etiology + head trauma is probably a concussion, but obviously that is more of a judgement call, and is not black and white.


Honestly tikidoc, I assume most people on the Penguins board are men unless they state otherwise. It is just numbers. Everything else though, your information has been appreciated. Thank you.
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Re: Let's get smart on what a concussion is.

Postby Sigwolf on Sun Apr 07, 2013 10:34 pm

tikidoc wrote:
Scott wrote:Wow. Let me see if I can help you with this. Nothing said whatsoever was sexist.


What was sexist was the assumption that I was a man. And when someone who assumes that a medical professional must be a man (Mr. medical student, remember?) also references Susie Homemaker, it's probably a good bet that they have sexist tendencies.

The post about Mayo clinic was not mine, yet you attacked me for the content of that post (which was mostly correct, if maybe a little oversimplified). As far as the Mayo clinic site that was referenced, it is a site designed for patients/general public and therefore is going to be somewhat generalized and simplified. They are not going to go into the details of subtleties of diagnosing mild TBI.

But the peer-reviewed literature that I quoted is pretty clear. LOC + head trauma = concussion. At a minimum. That is black and white, and it is written in black and white. In the medical literature. Persistant headache that can't be explained with another etiology + head trauma is probably a concussion, but obviously that is more of a judgement call, and is not black and white.



I, for one, appreciate your patience. I think Scott is being unbelieveably thick-headed. I had an appendectomy years ago, and for some reason I would never talk condescendingly to a doctor about what is involved in diagnosing appendicitis. (not to mention several diagnosed concussions. :) )
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Re: Let's get smart on what a concussion is.

Postby ExPatriatePen on Sun Apr 07, 2013 10:38 pm

tikidoc wrote:
Scott wrote:tikidoc,
or should I say mr Med Student.


1. I am not a medical student. I graduated from medical school in 1994.
2. I am not a Mr. Nice sexist assumption though. I suppose I shouldn't be surprised, given your "Suzy Homemaker" comment. News flash, women can be both physicians and hockey fans.

And you jumped to a whole lot of other conclusions regarding headaches. The primary issue I have been addressing is the fact that loss of consciousness with a head injury equals mild traumatic brain injury, AKA concussion. I mentioned headache in that it can also be a symptom of concussion. Certainly if someone has a headache after a head trauma, one should consider other causes, but persistant headache that started with the trauma and does not have another explanation would be considered evidence of concussion. As would nausea/vomiting, mental status changes, confusion, etc. But if you go back and read my post, I did not say that headache after head trauma always equals concussion. I said that it CAN BE a symptom. You are the one who made that an absolute.

With no loss of consciousness, you are correct in that it is not black and white. That is where clinical judgement and careful history taking is important, to try to tease out if the symptoms are caused by the head injury.

With loss of consciousness with associated head trauma, it absolutely is black and white. And that was the reason I posted the two definitions that have been published in peer-reviewed journals. That you are ignoring.


Please continue to post here on LGP.

Your presence is a breath of fresh air in relation to many others. You have my respect and appreciation.
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Re: Let's get smart on what a concussion is.

Postby Idoit40fans on Mon Apr 08, 2013 8:11 am

Scott wrote:tikidoc,
or should I say mr Med Student.

your sarcasm is very inane however I will respond. A concussion is one of those symptoms that isn't identical from one case to the next. Symptoms can vary from one person to the next. One of the reasons they monitor for concussion type symptoms because they may flare up after some time of the incident.

So Mr Med student, since you feel that anyone that experiences those symptoms that you mentioned has a concussion, since its so black and white, then how on earth do the Steelers even field a team every week. If a player has a headache after having played a tough physical game, then according to you
he is concussed. Right?


I stopped reading here, but I definitely believe your other post when you comment about having suffered a massive head trauma.
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Re: Let's get smart on what a concussion is.

Postby tikidoc on Mon Apr 08, 2013 12:30 pm

Rylan wrote:
tikidoc wrote:
Scott wrote:Wow. Let me see if I can help you with this. Nothing said whatsoever was sexist.


What was sexist was the assumption that I was a man. And when someone who assumes that a medical professional must be a man (Mr. medical student, remember?) also references Susie Homemaker, it's probably a good bet that they have sexist tendencies.


Honestly tikidoc, I assume most people on the Penguins board are men unless they state otherwise. It is just numbers. Everything else though, your information has been appreciated. Thank you.


Yea, I realize that, and had he not also made the Susie Homemaker reference, along with his general snarkiness and condescending attitude, I would have let it slide. I know I'm in the minority on the board.

Thanks, guys*, for the support. It's much appreciated.

*ETA I'm a midwesterner, we use "guys" like southerners use "y'all", as a generic term for both genders.
Last edited by tikidoc on Mon Apr 08, 2013 1:09 pm, edited 2 times in total.
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Re: Let's get smart on what a concussion is.

Postby Lt. Dish on Mon Apr 08, 2013 12:56 pm

tikidoc wrote:
Rylan wrote:
tikidoc wrote:
What was sexist was the assumption that I was a man. And when someone who assumes that a medical professional must be a man (Mr. medical student, remember?) also references Susie Homemaker, it's probably a good bet that they have sexist tendencies.


Honestly tikidoc, I assume most people on the Penguins board are men unless they state otherwise. It is just numbers. Everything else though, your information has been appreciated. Thank you.


Yea, I realize that, and had he not also made the Susie Homemaker reference, along with his general snarkiness and condescending attitude, I would have let it slide. I know I'm in the minority on the board.

Thanks, guys, for the support. It's much appreciated.


Aloha, tikidoc, and mahalo for sharing your expertise. I'll tell you that we female fans here are the minority, but we're fun, vocal, and, in my experience, most welcome. You've been a member for ages; don't forget to participate in the frivolity, as it's good stress relief. (As you can see, I've been incredibly stressed out... :lol: )
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Re: Let's get smart on what a concussion is.

Postby Pavel Bure on Mon Apr 08, 2013 1:43 pm

tikidoc wrote:
Scott wrote:Wow. Let me see if I can help you with this. Nothing said whatsoever was sexist.


What was sexist was the assumption that I was a man. And when someone who assumes that a medical professional must be a man (Mr. medical student, remember?) also references Susie Homemaker, it's probably a good bet that they have sexist tendencies.

The post about Mayo clinic was not mine, yet you attacked me for the content of that post (which was mostly correct, if maybe a little oversimplified). As far as the Mayo clinic site that was referenced, it is a site designed for patients/general public and therefore is going to be somewhat generalized and simplified. They are not going to go into the details of subtleties of diagnosing mild TBI.

But the peer-reviewed literature that I quoted is pretty clear. LOC + head trauma = concussion. At a minimum. That is black and white, and it is written in black and white. In the medical literature. Persistant headache that can't be explained with another etiology + head trauma is probably a concussion, but obviously that is more of a judgement call, and is not black and white.

This dude has his panties in a bunch. A very intelligent masculine bunch. For sure a type A personality. Very dominant guy here.
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Re: Let's get smart on what a concussion is.

Postby LostPenguin on Tue Apr 09, 2013 6:22 am

Updated from a 1982 lyric:

"It was a bit surprising that the girl blinded ME with science!"
--- Scott, to himself, 2013
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Re: Let's get smart on what a concussion is.

Postby no name on Tue Apr 09, 2013 8:04 am

concussion is a 4 letter word on this board.
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Re: Let's get smart on what a concussion is.

Postby Pitt87 on Tue Apr 09, 2013 8:10 am

Rylan wrote:
tikidoc wrote:
Scott wrote:Wow. Let me see if I can help you with this. Nothing said whatsoever was sexist.


What was sexist was the assumption that I was a man. And when someone who assumes that a medical professional must be a man (Mr. medical student, remember?) also references Susie Homemaker, it's probably a good bet that they have sexist tendencies.

The post about Mayo clinic was not mine, yet you attacked me for the content of that post (which was mostly correct, if maybe a little oversimplified). As far as the Mayo clinic site that was referenced, it is a site designed for patients/general public and therefore is going to be somewhat generalized and simplified. They are not going to go into the details of subtleties of diagnosing mild TBI.

But the peer-reviewed literature that I quoted is pretty clear. LOC + head trauma = concussion. At a minimum. That is black and white, and it is written in black and white. In the medical literature. Persistant headache that can't be explained with another etiology + head trauma is probably a concussion, but obviously that is more of a judgement call, and is not black and white.


Honestly tikidoc, I assume most people on the Penguins board are men unless they state otherwise. It is just numbers. Everything else though, your information has been appreciated. Thank you.


This. People dislike truth. Keep telling it, Doc. :thumb:
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Re: Let's get smart on what a concussion is.

Postby headh on Tue Apr 09, 2013 8:31 am

tikidoc wrote:
Scott wrote:tikidoc,
or should I say mr Med Student.


1. I am not a medical student. I graduated from medical school in 1994.
2. I am not a Mr. Nice sexist assumption though. I suppose I shouldn't be surprised, given your "Suzy Homemaker" comment. News flash, women can be both physicians and hockey fans.

And you jumped to a whole lot of other conclusions regarding headaches. The primary issue I have been addressing is the fact that loss of consciousness with a head injury equals mild traumatic brain injury, AKA concussion. I mentioned headache in that it can also be a symptom of concussion. Certainly if someone has a headache after a head trauma, one should consider other causes, but persistant headache that started with the trauma and does not have another explanation would be considered evidence of concussion. As would nausea/vomiting, mental status changes, confusion, etc. But if you go back and read my post, I did not say that headache after head trauma always equals concussion. I said that it CAN BE a symptom. You are the one who made that an absolute.

With no loss of consciousness, you are correct in that it is not black and white. That is where clinical judgement and careful history taking is important, to try to tease out if the symptoms are caused by the head injury.

With loss of consciousness with associated head trauma, it absolutely is black and white. And that was the reason I posted the two definitions that have been published in peer-reviewed journals. That you are ignoring.


Your point stands on it's own merit. Why the immature reaction to the usage of "Mr."?
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Re: Let's get smart on what a concussion is.

Postby tikidoc on Tue Apr 09, 2013 10:47 am

headh wrote:
tikidoc wrote:
Scott wrote:tikidoc,
or should I say mr Med Student.


1. I am not a medical student. I graduated from medical school in 1994.
2. I am not a Mr. Nice sexist assumption though. I suppose I shouldn't be surprised, given your "Suzy Homemaker" comment. News flash, women can be both physicians and hockey fans.

And you jumped to a whole lot of other conclusions regarding headaches. The primary issue I have been addressing is the fact that loss of consciousness with a head injury equals mild traumatic brain injury, AKA concussion. I mentioned headache in that it can also be a symptom of concussion. Certainly if someone has a headache after a head trauma, one should consider other causes, but persistant headache that started with the trauma and does not have another explanation would be considered evidence of concussion. As would nausea/vomiting, mental status changes, confusion, etc. But if you go back and read my post, I did not say that headache after head trauma always equals concussion. I said that it CAN BE a symptom. You are the one who made that an absolute.

With no loss of consciousness, you are correct in that it is not black and white. That is where clinical judgement and careful history taking is important, to try to tease out if the symptoms are caused by the head injury.

With loss of consciousness with associated head trauma, it absolutely is black and white. And that was the reason I posted the two definitions that have been published in peer-reviewed journals. That you are ignoring.


Your point stands on it's own merit. Why the immature reaction to the usage of "Mr."?


He condescendingly addressed me as "Mr. medical student" five times in one post. It was obnoxious. I called him on it. In one sentence, which has resulted in an awful lot of attention, which I find interesting, in and of itself.

The vast majority of what I have been writing has been addressing his assertions with medical facts, definitions and literature.
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Re: Let's get smart on what a concussion is.

Postby Malkamaniac on Tue Apr 09, 2013 10:52 am

This thread delivers.

Image
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Re: Let's get smart on what a concussion is.

Postby nastystang05 on Tue Apr 09, 2013 2:04 pm

Gaucho wrote:What happened to nastystang? I sure hope moondart didn't chase him off for good.

I'm still around. I just didn't want to write too much and have the thread closed again lol. Too much waste of time.

I think it was confirmed today that Neal has a concussion. Its hard to say how he is progressing since the pens organization has been tight lipped on this one. Information that tiki is giving is good info even though it comes from generic internet sites the information provided is still correct.

BTW anyone hear me on Doc Talk on AM 1170 speaking about concussions a few weeks ago?
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Re: Let's get smart on what a concussion is.

Postby tikidoc on Tue Apr 09, 2013 2:50 pm

nastystang05 wrote:
Gaucho wrote:What happened to nastystang? I sure hope moondart didn't chase him off for good.

I'm still around. I just didn't want to write too much and have the thread closed again lol. Too much waste of time.

I think it was confirmed today that Neal has a concussion. Its hard to say how he is progressing since the pens organization has been tight lipped on this one. Information that tiki is giving is good info even though it comes from generic internet sites the information provided is still correct.

BTW anyone hear me on Doc Talk on AM 1170 speaking about concussions a few weeks ago?


Virtually all published medical research is available on the Internet. I rarely look at physical paper journals anymore, because all the major journals are online, and I can download articles of interest, put them in my dropbox folder, and read them on my ipad whenever I want. I wish more journals would give the option to just have online access, because I usually toss the paper ones soon after they arrive.

The definition of concussion that I posted from the AANS was from their website, and was meant for the general public, as was the definition from Mayo posted by the starter of the thread. That does not make them invalid, but they were meant to help explain what a concussion is to the public, and were in plain english.

The diagnostic criteria from the World Health Organization's Collaborative Center Task Force on Mild Traumatic Brain Injury and American Congress of Rehabilitation Medicine Special Interest Group on Mild Traumatic Brain Injury were both peer-reviewed and published in major journals.
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Re: Let's get smart on what a concussion is.

Postby headh on Tue Apr 09, 2013 2:55 pm

tikidoc wrote:
headh wrote:
tikidoc wrote:
Scott wrote:tikidoc,
or should I say mr Med Student.


1. I am not a medical student. I graduated from medical school in 1994.
2. I am not a Mr. Nice sexist assumption though. I suppose I shouldn't be surprised, given your "Suzy Homemaker" comment. News flash, women can be both physicians and hockey fans.

And you jumped to a whole lot of other conclusions regarding headaches. The primary issue I have been addressing is the fact that loss of consciousness with a head injury equals mild traumatic brain injury, AKA concussion. I mentioned headache in that it can also be a symptom of concussion. Certainly if someone has a headache after a head trauma, one should consider other causes, but persistant headache that started with the trauma and does not have another explanation would be considered evidence of concussion. As would nausea/vomiting, mental status changes, confusion, etc. But if you go back and read my post, I did not say that headache after head trauma always equals concussion. I said that it CAN BE a symptom. You are the one who made that an absolute.

With no loss of consciousness, you are correct in that it is not black and white. That is where clinical judgement and careful history taking is important, to try to tease out if the symptoms are caused by the head injury.

With loss of consciousness with associated head trauma, it absolutely is black and white. And that was the reason I posted the two definitions that have been published in peer-reviewed journals. That you are ignoring.


Your point stands on it's own merit. Why the immature reaction to the usage of "Mr."?


He condescendingly addressed me as "Mr. medical student" five times in one post. It was obnoxious. I called him on it. In one sentence, which has resulted in an awful lot of attention, which I find interesting, in and of itself.

The vast majority of what I have been writing has been addressing his assertions with medical facts, definitions and literature.


You earned the fact that you graduated. You addressed that in two sentences. Very straight forward stuff on your part.

You were born a woman. You addressed that in a much more dramatic and elongated manner. I was just curious as to why.

Now I am curious as to why you are trying to down play how petty you were about it. No real reason to reply to me. I just found your over the top reaction to be "obnoxious" to use your term.

edit...Im actually far more curious about broken jaws. Is Sid gonna make it back for the playoffs? Obviously I am asking for your opinion because I respect the fact that you graduated from medical school?
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Re: Let's get smart on what a concussion is.

Postby nastystang05 on Tue Apr 09, 2013 3:08 pm

No reason to be defensive I agree with all that you have posted. Although it is tough not be be around these parts. I started a thread just like you did to try and educate. I even used referenced sources and people try to mock you and run you out of here. But there are also really cool members here that do appreciate your time and expertise.
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Re: Let's get smart on what a concussion is.

Postby Idoit40fans on Tue Apr 09, 2013 3:15 pm

So is headh just someone's new account? No one joins the site and immediately starts acting like this.
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Re: Let's get smart on what a concussion is.

Postby Pavel Bure on Tue Apr 09, 2013 4:50 pm

Idoit40fans wrote:So is headh just someone's new account? No one joins the site and immediately starts acting like this.

Noobs :pop:
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