Part 2 of 2 Parts
ELLSWORTH — For Dagan Berenyi, the hardest part of having a concussion was constantly fielding the question, “You seem fine, why aren’t you wrestling?”
“You can’t put a cast on your head,” says Berenyi, a recent Ellsworth High School graduate. “Some people understand, but some people just don’t get it.”
Measuring damage at the cellular level is complicated. So is finding the right approach to recovering from a concussion. Athletes going through the process often feel isolated and misunderstood, and some will do just about anything to hide their head injuries.
Last fall, Mariah Kinghorn woke up with a pounding headache the day after she suffered a concussion playing soccer.
The Sumner Memorial High School junior recoiled from the sun when her grandmother opened her blinds, feeling — as she describes — like she had just had her pupils dilated at the eye doctor’s.
“Everything was heightened times 10,” Kinghorn says of her sensitivity to noise and light.
Simple things bothered her, such as car headlights and the swooshing sound of passing vehicles. At school, Kinghorn struggled to keep her eyes open in the brightly lit classrooms. She says chatter in the hallways and lunchroom grated on her as if students were screaming in her ears.
“And the bell…” Kinghorn shakes her head. “No one realizes what you’re going through unless they’ve experienced it for themselves.”
Concussions are both invisible and hard to define, which makes validating the pain they cause difficult for the young athletes experiencing them.
“I have to say, school is hell for concussions,” says Beckett Slayton, a baseball and basketball standout for George Stevens Academy. “There is the academic stress and struggles focusing and retaining information. On top of that, there is the social stress of missing school and friends not understanding.”
Slayton, a senior, still lives in the gray area that surrounds post-concussion syndrome. After suffering a concussion that sidelined him from sports for a year and a half, he remains unsure which headaches are signs of regression and which are the new norm. Every doctor he visits tells him something different.
“It’s hard medicine, but it’s soft science,” says Dr. Bruce Hamilton-Dick, an orthopedic surgeon at Maine Coast Memorial Hospital. “In the absence of having the X-ray that says the bone is broken, how do you tell the brain is broken?”
Aside from questionnaires and sideline evaluations, one of the most common tools schools use to detect head injuries is called the ImPACT, or Immediate Post-Concussion Assessment and Cognitive Testing. High school athletes take the 25-minute test before each season to establish a baseline of their neurological function. The computer software program measures verbal and visual memory, processing speed and reaction time.
But, like all concussion tests, it requires honesty from athletes.
Berenyi actually did better on the ImPACT after getting a concussion — a phenomenon he admits was no fluke. He says many athletes, himself included, intentionally score poorly on the baseline test to mask the effects of a potential concussion.
“We’d talked about sandbagging it the first time,” Berenyi says. “We were going to play.”
Trent Mahon, a senior at Ellsworth High School, also manipulated his ImPACT results. He suffered a concussion in a basketball game in January after he took an elbow to the temple and smacked his head on the hardwood floor. He says he felt dizzy and even vomited, which he blamed on a sandwich he ate.
“I like basketball a lot,” Mahon says. “I didn’t want to say anything because I really wanted to play.”
At the next practice, Mahon jogged up and down the court for about two minutes before dropping to his knees in tears.
“My head just blew up,” he says. “I felt like everything snapped. I couldn’t do it anymore.”
Athletes also downplay their symptoms because they don’t want to disappoint their teammates. Even the most well-intentioned coaches face a powerful opponent in peer pressure.
Dwayne Carter, coach of George Stevens Academy’s 2016 state championship basketball team, has drifted to the more cautious end of the spectrum when it comes to detecting head injuries. Carter learned of the struggles posed by concussions firsthand after he suffered one playing basketball last spring. He benched several players for suspected concussions throughout last season while remaining particularly vigilant in Slayton’s case.
“If you go back too soon, you might be done forever,” Carter says.
Once, at practice, Carter noticed Slayton looking tired and what he can only describe as “vague.”
“That’s why I kept having you back off, which I think was the right thing to do,” Carter says to Slayton in a joint interview. “I think it paid off. Right?”
“Yeah,” Slayton responds. His tone isn’t convincing.
“Even though you might have gotten mad,” Carter adds.
“That goes back to the thing about…” Slayton’s voice trails off. “Milking it.”
“But I knew you weren’t milking it,” Carter responds.
“I know,” Slayton says, “but the team doesn’t.”
Dr. Sheena Whittaker, a pediatrician who works with athletes suffering from concussions at MCMH, says some schools and coaches have even become a little too cautious.
“Which is good,” Whittaker adds. “We don’t have a clear handle on what the actual damage is and how to document it, so we have to over-treat it.”
Recovering from a concussion requires limited mental stimulation, which means avoiding screens such as televisions, computers, video games and cell phones until symptoms subside. Even activities such as reading can stress the brain and slow recovery.
Kinghorn left school early the day after getting her concussion, and she didn’t return for two weeks. She says she spent most of that time in her dark bedroom, doing nothing.
“People were like, ‘No way. You didn’t need to be out — you look fine,’” Kinghorn says. “I just didn’t want them to be disappointed or think, ‘She’s fine, she just doesn’t want to come back.’ Of course I wanted to. It was horrible not being in school.”
Lucas Theoharidis, a recent graduate from George Stevens Academy who got a concussion in September, says a classmate once responded to him getting to retake a test with the comment, “Wow, you’re really milking this concussion, aren’t you?”
“I think they think you’re at home watching Netflix,” Theoharidis says. “If you couldn’t do anything at your house, you’d rather be in school.”
Theoharidis suffered his concussion playing soccer. He says he felt hazy after missing a head ball and banging heads with an opposing player, but he stayed in the game because he didn’t want to disappoint anyone. Eight months later, on March 30, Theoharidis still wears sunglasses indoors. Screens triggered his headaches so, for months, he couldn’t use his phone or computer to communicate with friends.
“They’d try to talk to me, but they’d send me a message on Facebook,” Theoharidis says. “I would tell them that I really shouldn’t be using Facebook, but they would just ignore me.”
“I hated my house,” says Mahon, adding he initially couldn’t even work on puzzles without pain. “I didn’t really talk to anyone for a solid month.”
Mahon, Theoharidis, Slayton and Berenyi have lost track of how much school they missed throughout recovery. But they measure their absence in months, not days.
“You can have a concussion that goes untreated and doesn’t really affect you a lot, and you can have one that changes your life for the better part of a year or so,” Berenyi says. “It’s not even just about sports. It’s everything.”
Lisa Theoharidis, Lucas’ mom as well as the school nurse at George Stevens Academy, has seen the struggles students with concussions face trying to maintain their relationships.
“The longer the concussion lasts, the more disconnected you are from society,” Lisa Theoharidis says. “If you’re not in school and you can’t use technology, you’re totally disconnected from the world. Their world.”
As a result, Dr. Whittaker says, the recovery can lead to secondary issues such as anxiety and depression.
“So the pendulum is already swinging away from that,” Whittaker says, “because a lot of kids in sports thrive on being busy and doing well. Then you put them in a dark room with nothing to do for days on end.
“It’s finding that balance between the two.”
Slayton had tutors visit him at home when he was absent. Lucas Theoharidis was allowed to turn off the lights in his classes, though his mom says he skipped school on rainy days when the sun wasn’t filtering in through the windows.
Berenyi occasionally took naps in the front office and worked in rooms with less commotion at school. He recalls one week where he sacrificed sleep to catch up on homework. As a result, his symptoms, such as headaches and moodiness, got “drastically worse.”
“You have to take off that pressure,” Whittaker says. “For that high-achieving kid who thinks, ‘I’m failing all my classes,’ they’re going to lie about everything so they can get back.”
Berenyi still grapples with the timing of his concussion. He was just 10 minutes away from competing in the Northern Maine soccer championship, which — without Berenyi — Ellsworth lost 2-1. And with colleges scouting talented wrestlers in their senior year, Berenyi — a 2015 state champion — would miss the entire season as well as his shot at earning an athletic scholarship.
But, as Berenyi has learned throughout the year, the cost of a concussion could be much worse.
“I’m more aware now,” Berenyi says. “You’ve got to listen to your body. Your life revolves around getting better.”
For more information about concussions and how to support research efforts, visit the Maine Concussion Management Initiative’s website at web.colby.edu/mcmi.
Click here for Part 1.