Father of a 14-year-old hockey player

It was Saturday November 21, 2009. My son was playing an away game with his bantam AAA hockey team. I recall the play that caused my son’s concussion as if it happened yesterday. My son was trying to chip the puck beyond a pinching defenseman so that the puck would clear the zone. In so doing my son was stretching-reaching for the puck along the boards that left him exposed to the hit. In making the stretching motion my son’s head was about a foot below the glass – and that is when another player came up hard from the side and hit my son with his head slamming against the boards. I saw him go down. I knew he was hurt. He initially lay motionless on the ice. But he had been successful in chipping the puck out of his zone – so the play had transitioned away from him. The play continued without the referee blowing the whistle. My son pulled himself to his feet and staggered to his bench. I initially thought he had aggravated a groin injury he had just recovered from. I watched him on the bench – the trainer spoke briefly to him. My son did not miss a shift for the remainder of that first period. I watched his play – he seemed OK. I watched him during the first period break – and it was then I had some concerns about his health – he was leaning against the boards – his head resting on the top of the boards – he was not paying attention to the coach – but no one on the bench was picking up on my son’s inattention – in hindsight I should have gone to the bench to ask the trainer as to what was up – but our hockey culture does not encourage this behaviour from parents.

My son continued to play through the second period – and oddly enough his play was fine. I was focussing on his skating (groin injury?) and his skating was fine. However – with 5 minutes remaining in the second period the trainer escorted my son from the bench to the dressing room. I met them there. The trainer advised that my son “had no idea where he was”. We asked my son a few basic questions – and it was verified – he had suffered a concussion. My son was unable to tell us what city we were in, who the game was against, what time the game had started. He also indicated that he had a headache and he felt “slightly” nauseous. This was my first experience with this type of injury. I was unaware as to what other symptoms to look for. The team trainer – a nice parent volunteer – but with no medical training – was equally unable to assist any further. We helped my son undress and I took him to a local hospital. The emergency doctor in my view downplayed the injury. He advised that there was nothing to fear about – that over the next couple of weeks my son would likely become symptom free and be able to return to play. I accepted this medical advice.

On Monday (two days later) we sent our son to school (although he was complaining of a headache). We did keep him off the ice – this was not based upon any specific advice – we just felt it prudent since our son was not yet feeling 100%. Our local family doctor suggested a chiropractor – and we did follow up with this type of treatment. But two weeks later my son was not symptom free. My son is a stoic boy – he was not constantly complaining – we would have to ask him – and he was honest with us that “he did not feel well” – but in hindsight he was obviously downplaying the symptoms. I do know he was frustrated that we were not permitting him to practise or play games.

By this point in time I was worried. It had been more than 2 weeks and he was not OK. I went on the web and researched the injury. We reside in a small city that does not have a sports specialist in this area of medicine. While surfing the web I came across some excellent educational material on the Hockey Canada website. I called my son to the computer screen so as he could read the material with me. A few minutes into jointly reading from the computer screen my son said he felt sick to his stomach – he had a severe headache and he had to lay down immediately (he did so on the floor beside my computer station). Now I was truly worried. This is behaviour I was not expecting two weeks after suffering the injury.

Continuing my search on the web I came across Dr. Paul Echlin’s name as a medical practitioner with an excellent reputation in this field – and fortunately for us he had a satellite practice a one hour’s drive from our home. I called his office on a Wednesday morning. I spoke with his nurse. She advised that Dr. Echlin had no immediate openings – however she sensed my desperateness – she asked for the details as to how the injury occurred and his symptom’s. She advised that she would speak with Dr. Echlin and call us back. She called the next day – Thursday – and said Dr. Echlin would see our son the next day. And on Friday I drove my son to see Dr. Echlin – who proceeded to spend two hours asking my son questions and placing him through a series of tests.

At this time it was not our hockey’s association policy to complete baseline tests. Consequently Dr. Echlin din not have this diagnostic tool as a reference. Nevertheless he did confirm that our son was suffering from a severe concussion.

Dr. Echlin explained to us the seriousness of this injury and the frustration that one can experience during the recovery process. He emphasized with our son the importance for him to be completely honest in conveying how he was feeling (symptoms) throughout the recovery process. And he counselled that at a point our son might consider himself symptom free, but that this would not be entirely the case, and he would have to wait further before he was cleared to play. Dr. Echlin advised that this was a critical period, as the patient often feels well enough to return to contact sport, but it is premature.

All of what was prognosticated by Dr. Echlin is precisely what occurred to our son. The initial step we took (following Dr. Echlin’s advice) is we kept our son home from school for two consecutive weeks. In the third week he returned to school for half days. We gave our son’s brain complete rest. He did not play video games, use a computer, and initially he did not even watchTV. Dr. Echlin monitored our son’s progress every week in the initial month. Over time our son’s concussion symptom’s abated, however it was in this period that Dr. Echlin warned that he should not return to play prematurely. While our son was frustrated that he could not play the game he loves, he understood the importance of following Dr. Echlin’s advice.

Three month’s after the injury Dr. Echlin cleared our son to play. I’ll add that during this time our 14 year old son did not miss one practice or game (home or away) – as a spectator supporting his team-mates. We had the good fortune of having a supportive coach who placed no pressure upon our son to return to play prematurely.

Dealing with this injury was a learning experience for us and our son. We were fortunate to find excellent medical treatment that assisted us immensely in educating us about this injury and the importance of taking it seriously. We owe Dr. Echlin and his staff a vote of thanks. Over two year’s after the injury our son continues to play the game he loves without further incident – but we are mindful that it is a sport that such an injury could reoccur – and if it does we will be better able to recognize it and deal with it.