Docnotes

Soccer Headgear

All of my devoted readers (Hi Mom!) know that my son had had his share of concussions playing sports.  In the Fall of 2007, he landed on his head in a soccer game.  Spring of '08 there was the baseball that hit him in the head/eye .. and the last Fall - he was hit in the side head with a line-drive soccer ball.

Concussion #3 within 12 months was almost the last piece of straw on the camel's back.   With each successive concussion, the injury was worse - even though the inciting events may actually have been similar in severity.

While the parents' decisions on matters like this are of course always public - in this case - they also reflect my medical decision-making skills (or lack thereof!) as many of the parents and kids on the community have known me as their family physician.  So while I would need to make the right decision for Sam - I also need to make sure that other parents understand the rationale for the decisions - and perhaps help use these events to bring about a change.

After a full recovery - we agreed to allow him to return to playing soccer with one caveat:  he is required to wear a soccer helmet.   he will always wear the headgear when he plays soccer.  If he forgets it for a practice or game - he doesn't play.  when he goes to college he will wear it.  If he ends up being a pro soccer player - the headgear will be there.

Why will he always wear this?

- It may prevent another concussion  

- It's comfortable and doesn't interfere with his play at all

- If he has another concussion - the outcome will be even worse.  It could even kill him

Would soccer headgear protect other kids from this?

Yes.  Here's a recent study that demonstrates the protective effect of headgear in real soccer players - and is associated with a significantly lower incidence of concussion in boys.  Other studies (here, here and here) showed that in lab experiments - headgear reduces the force of impact when heading the ball.

A recent study demonstrated that the protective effect may not be present for girls.

As I read these papers - and others - it becomes clear that much of the focus is on heading, but heading is certainly not the only reason kids get concussions.  In Sam's case - none of the events involved Sam's volitional heading of a ball.  Indeed - this paper looked at the causes of concussions in soccer players and found that:

 The most frequent injury mechanism was elbow to head contact, followed by head to head contact in heading duels.

So perhaps girls would still be protected - as they would have SOMETHING between that head and the oncoming elbow!

There is a conversation now beginning amongst some of the team parents about whether headgear should be required of all players.

Argument for having all kids wear them:

- It will prevent concussions. Note that I didn't say might prevent concussions. 

Arguments against:

- They look dorky

- They are expensive

Obviously - I had to put these two out on the table.  The kids will object because they are dorky and the parents will object because they cost $35.  I'm sure we can buy them in bulk to save some money - or perhaps we don't really NEED those cool matching back-packs with the embroidered names on them.  Remember when people didn't wear bike helmets?  Ski helmets? Seat belts?  How long do we have to wait before we get smart here?  

Spit Testing - Fun fact about Llamas

"Spit testing". Bring the potentially pregnant dam to an intact male. If the stud attempts to breed her and she lies down for him within a fairly short period of time, she is not pregnant. If she remains on her feet, spits, attacks him, or otherwise prevents his being able to mate, it is assumed that she is probably pregnant. This test gets its name due to the dam spitting at the male if she is pregnant.

Llama - Wikipedia, the free encyclopedia

Goin to Ecuador!

I know it's been a while.    I've been thinking that the reason I don't post here so often any longer  is because my thoughts are the intellectual property of the company I work for - which may very well be the case - but I recall that my blogging also started to slow down when my mom discovered the blog.

Hmm .. I expect that this is fairly common.  My son blocked me from Facebook when he discovered that I had an account.

So the latest news is that I'm going to Ecuador soon.  Read all about the adventure here.  I'll be blogging the adventure .. and as you may see  ..  It would be fantastic if you could help support my plan to bring down some materials to help teach doctors "best practices" in maternity care.

Allscripts Prenatal

My baby went GA today - at roughly 55 weeks gestation - she was a bit post-dates .. but the parents are happy. :-)

Recalls, action-able information, and health IT

Yesterday's phone message from our local supermarket about the Progresso soup recall was impressive.  Thanks to the wonders of information technology, we got this phone call before I saw mention of the issue on the news.   How long does it take for us to make information like this available in healthcare?  Much longer.  We need to connect the information to the actions, and the people who can perform those actions - much better.

Nine Years of blogging - and a fresh start

It's now been nine years that I've boon blogging. If your name isn't Dave Winer, Evan Williams or David Theige - you probably didn't know what a blog was back then.

The past two years - this blog has been stale - due to my professional role mirroring my personal interests in a way that makes my thoughts potentially company secrets that can't be shared.

I'm working on ways to change that so that this blog once again becomes the valuable asset that it once was. Stay tuned.

My Six-Word Memoir

A few years ago - when the Web Was Young(er) .. some folks at Smith Magazine solicited six-word memoirs from those of us using this neat new service called twittr  (yes - there was no "e" back then).

 

I sent one in and forgot about it until yesterday Rachel Fershleiser e-mailed me and told me that my six-word was going to be published in the new expanded edition of Not-Quite-What-I-Was-Planning.

 

Drum roll .. what is my six-word?  (I had to e-mail Rachel for it .. I had no idea what it was) ...

"Dad dreams different mousetrap. Oops. Again."

links for 2008-09-24

• Still a Ways to Go: Widespread EHR Adoption Remains Off in the Distance

Gordon's RSS

Poor John. He couldn't get an RSS feed out of google reader without a cookie. Enter Dappit Kinda nuts to get the RSS from what is essentially a screen-scrape of the HTML. Oh well .. in desperate times, we take desperate measures.

links for 2008-09-22

• What's the Differerence Between an EHR (Electronic Health Record) and EMR (Electronic Medical Record)?